Blue Button 2.0 Implementation Guide

CodeSystem: clm-poa-ind-sw1

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Claim Diagnosis Code I Diagnosis Present on Admission (POA) Indicator Code

The present on admission (POA) indicator code associated with the diagnosis codes (principal and secondary). In response to the Deficit Reduction Act of 2005, CMS began to distinguish between hospitalization diagnoses that occurred prior to versus during the admission. The objective was to eventually not pay hospitals more if the patient acquired a condition (e.g., infection) during the admission. This present on admission (POA) field is used to indicate whether the diagnosis was present on admission. Medicare claims did not indicate whether a diagnosis was POA until 2011. Source: https://bluebutton.cms.gov/resources/variables/clmpoaind_sw1

This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-poa-ind-sw1 defines the following codes:

CodeDisplayDefinition
Y Diagnosis was present at the time of admission (POA)Diagnosis was present at the time of admission (POA)
N Diagnosis was not present at the time of admissionDiagnosis was not present at the time of admission
U Documentation is insufficient to determine if condition was present on admissionDocumentation is insufficient to determine if condition was present on admission
W Provider is unable to clinically determine whether condition was present on admissionProvider is unable to clinically determine whether condition was present on admission
1 Unreported/not used - exempt from POA reporting - this code is the equivalent code of a blank, however, it was determined that blanks were undesirable when submitting the dataUnreported/not used - exempt from POA reporting - this code is the equivalent code of a blank, however, it was determined that blanks were undesirable when submitting the data
Z Denotes the end of the POA indicatorsDenotes the end of the POA indicators
X Denotes the end of the POA indicators in special data processing situations that may be identified by CMS in the futureDenotes the end of the POA indicators in special data processing situations that may be identified by CMS in the future