A code to indicate that the diagnosis (in DGNS_CD_1–12 fields) was present at the time the order for inpatient admission (POA) occurred.
POA indicator is used to identify certain preventable conditions that are:
(a) high cost or high volume or both,
(b) result in the assignment of a case to a Diagnosis Related Group (DRG)* that has a higher payment when present as a secondary diagnosis, and
(c) could reasonably have been prevented through the application of evidence-based guidelines.
*States that do not use the grouper methodology may use CMS-approved methodology that is prospective in nature.
There is a POA indicator code associated with each diagnosis code (principal and secondary).
Source: T-MSIS Analytic File (TAF) Claims
|Y||Diagnosis was present at time of inpatient admission|
|N||Diagnosis was not present at time of 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 inpatient admission|
|1||Unreported/Not used. Exempt from POA reporting|
|Null/missing||source value is missing, unknown, or not on the valid value list or within the range of valid values|