Reason Code 34929 - Acute Care Claims Must Contain a Valid Present on Admission (POA) Indicator
When receiving a returned claim with a reason code 34929 associated with the POA indicator, verify that a “1” is not in the POA field. Each submitted diagnosis should have an associated POA, unless that code is exempt. If you submitted more than nine diagnosis codes, key F6 to see additional codes in Direct Data Entry (DDE) to ensure all codes were submitted with valid POA indicators.
For a list of exempt POA codes, please refer to the Hospital-Acquired Conditions/Coding page on the CMS website.
POA Indicator Options and Definitions
| Code | Reason for Code |
|---|---|
| Y |
Diagnosis was present at time of inpatient admission. CMS will pay the Complicating Condition/Major Complicating Condition (CC/MCC) DRG for those selected Hospital Acquired Conditions (HACs) that are coded as "Y" for the POA Indicator. |
| N |
Diagnosis was not present at time of inpatient admission. CMS will not pay the CC/MCC DRG for those selected HACs that are coded as "N" for the POA Indicator. |
| U |
Documentation insufficient to determine if the condition was present at the time of inpatient admission. CMS will not pay the CC/MCC DRG for those selected HACs that are coded as "U" for the POA Indicator. |
| W |
Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission. CMS will pay the CC/MCC DRG for those selected HACs that are coded as "W" for the POA Indicator. |
| 1 |
Unreported/Not used. Exempt from POA reporting. This code is equivalent to a blank on the UB-04, however; it was determined that blanks are undesirable when submitting this data via the 4010A. CMS will not pay the CC/MCC DRG for those selected HACs that are coded as "1" for the POA Indicator. The "1" POA Indicator should not be applied to any codes on the HAC list. |