Claims : Submission

Present on Admission Indicator

All inpatient hospital providers are required to include POA indicator information for all primary and secondary diagnoses.

The DRA of 2005 requires a quality adjustment in DRG payments for certain HACs. Wisconsin Medicaid and BadgerCare Plus have adopted the HACs established by the federal CMS and reflected in the DRG payments. Reimbursement may be affected by this information. The CMS website contains the list of HACs that may affect reimbursement.

Present on Admission Indicator Options and Definitions

The following are POA indicator options and corresponding definitions:

• Y: This indicates that the diagnosis was present at the time of inpatient admission.
• N: This indicates that the diagnosis was not present at the time of inpatient admission.
• U: This indicates that the documentation is insufficient to determine if the condition was present at the time of inpatient admission.
• W: This indicates that the provider is unable to clinically determine whether the condition was present at the time of inpatient admission.