You have just taken a job as an inpatient coder at Pine Valley Community Hospita

Question

You have just taken a job as an inpatient coder at Pine Valley Community Hospital, a critical access hospital, after previosuly working at a large teaching facility in the same role. During your training at PVCH, you are suprised that the trainer stated that you do not have to assign the POA status on inpatient discharges. You decide to research this practice. After research, prove the trainer's state is correct. To prove thsi statement, provide reasons and at least two references used in your research. Minimum of 250 words

Explanation / Answer

POA status refers to Present on Admission. As per the Deficit Reduction Act of 2005 providers are supposed to mandatorily report POA indicators for all diagnoses (primary as well as secondary) that have been submitted on Medicare inpatient acute care claims. This is applicable for all discharges starting from October 1, 2007.

If POA indicator is not present then not only claims will be denied but also reimbursement may be affected. The POA indicators and options are: Y (this indicates that diagnosis was present at the time of admission), N (this indicates that diagnosis was not present at the time of admission), U (this indicates the insufficiency of documents for the purpose of determining if the condition was present or not at the time of admission), W (this indicates the inability of the provider to clinically determine the condition was present or not at the time of admission) and 1(this indicates that diagnosis is exempt from POA reporting).

However, few facilities are exempt from this requirement. These facilities are critical access hospitals, long term care hospitals, cancer hospitals, children’s hospital, inpatient psychiatric hospitals, inpatient rehabilitation facilities, long term care hospitals and per diem providers.

The Critical Access Hospital program was started in 1997 as a federal program and under the Balanced Budget Act. This federal program was introduced with an objective of offering small hospitals in rural areas. If these hospitals were not present then residents of the rural areas would have to travel long distances for the purpose of emergency care.

References:

1. CMS (Centers for Medicare and Medicaid Services). Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM5499.pdf

2. AHIMA (American Health Information Management Association). Retrieved from http://library.ahima.org/doc?oid=91932#.WshClNRuZdg

(274 words total)

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