|
Last Modified: 11/4/2011
Location: FL, PR, USVI
Business: Part A
34931
Inpatient acute care hospitals claim with a discharge date on or after 04/01/08 must have the number of present on admission (POA) indicators equal to the number of diagnosis codes. If a POA indicator is present, a diagnosis code must also be present for that occurrence.
• Exempt facilities include: Maryland waiver hospitals, cancer hospitals, children's hospitals, critical access hospitals (CAHs), long term care hospital (LTCH), inpatient rehabilitation facility (IRF), and inpatient psychiatric facilities (IPF). Hospitals paid under any other type of prospective payment system (PPS) other than acute care inpatient PPS are also exempt.
Effective 01/01/2011: POA indicator field equal to blank is only valid on 5010 and direct data entry (DDE) claims containing a diagnosis code that is present on the exempt list.
Resources/tips to avoid or correct this return to provider (RTP) code
Effective January 1, 2008, with change request 5679 (present on admission indicator systems implementation), you are required to use one of the valid values listed in the definition above with your diagnosis codes. Review this article 
posted in the Medicare A Bulletin, September 2007.
posted in the Medicare A Bulletin, September 2007.This change went into effect for inpatient admissions to general acute care hospitals in order to group diagnoses into the proper diagnoses related group (DRG).
Effective July 1, 2011, the POA indicator will be populated with a 'Z' for IPPS hospital providers using version 5010 837I health care claim format. This ensures grouper will apply the appropriate hospital-acquired conditions (HAC) logic, when applicable.
Please review the following articles for further clarification:
• Present on Admission (POA) Indicator reporting by acute inpatient prospective payment system (IPPS) hospitals 
-- Overview
Please use your browser's back button to return to the referring page.Source: FCSO Education Action Team
