Health Information Management

Understand payment implications of the POA indicator

HIM-HIPAA Insider, December 9, 2008

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In Medlearn Matters SE0841, CMS outlines payment implications for each of the present on admission (POA) indicator reporting options. Consider the following:

  • Y—CMS will pay the complications and comorbidities (CC)/major CCs (MCC) DRG for those selected hospital acquired conditions (HAC) that are coded as Y
  • N—CMS will not pay the CC/MCC DRG for those selected HACs coded as N
  • U—CMS will not pay the CC/MCC DRG for those selected HACs coded as U
  • W—CMS will pay the CC/MCC DRG for those selected HACs coded as W
  • 1—CMS will not pay the CC/MCC DRG for those selected HACs coded as 1. Coders should not report a 1 indicator with any codes on the HAC list. CMS will return these claims to the provider for correction.

To view SE0841, click here.



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