Present on Admission (POA) indicator coding
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This document governs the requirement to report Present on Admission (POA) indicator codes for inpatient diagnosis coding affecting Aetna members in New Jersey across Commercial and Medicare lines of business.
No material clinical or coverage changes in this revision.
POA Reporting Requirements
POA reporting criteria
Reporting requirements for Present on Admission (POA) indicators.
ALL of the following
- POA reporting applies to both Commercial and Medicare members.
ALL of the following
- A POA code is required for all primary and secondary inpatient diagnosis codes.
ALL of the following
- A POA code is not required for the admitting diagnosis.
ALL of the following
- This POA reporting requirement has been in effect since 10/1/2008.
POA Indicator Codes
| Y | Diagnosis was present at the time of inpatient admission. |
| N | Diagnosis was not present at the time of the inpatient admission. |
| U | Documentation insufficient to determine if condition was present at the time of inpatient admission. |
| W | Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of the inpatient admission. |
| 1 or spaces | Unreported/not used. Exempt from POA reporting. |
What Providers Must Do
Report POA for all primary and secondary inpatient diagnoses
Report POA indicator codes for all primary and secondary inpatient diagnosis codes for Commercial and Medicare members; POA is not required for the admitting diagnosis.
- Applies to both Commercial and Medicare lines of business.
- Requirement effective since 10/1/2008.
- POA not required for the admitting diagnosis code.
Key Definitions
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