Assigning a POA indicator for diabetes that progresses from controlled to uncontrolled during a hospital stay
HIM Connection, February 10, 2009
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A: There is no Coding Clinic on this particular topic. However, you would presumably assign the POA indicator N because controlled diabetes is a combination code, and a portion of the code was not POA (i.e., the uncontrolled diabetes). Consider the following excerpt from the ICD-9 Official Guidelines for Coding and Reporting:
Assign "N" if any part of the combination code was not present on admission (e.g., obstructive chronic bronchitis with acute exacerbation and the exacerbation was not present on admission; gastric ulcer that does not start bleeding until after admission; asthma patient develops status asthmaticus after admission).
Editor’s note: Shannon E. McCall, RHIA, CCS, CPC-I, director of coding and HIM at HCPro, Inc. in Chesterfield, VA, answered this question that originally appeared in the February issue of Briefings on Coding Compliance Strategies.
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