Which of the following claim forms are POA indicators required to be reported on?
- UB-04
- 837
- Both UB-04 and 837
- Neither UB-04 nor 837
POA indicators are required to be reported on both UB-04 and 837 claim forms.
Coding For Coverage: Choosing a code on the basis of what the insurance company will cover (pay for) rather than accurately reflecting the truth.
Trudy Turnipson is seen today for congenital keratoconus. Upon admission, her blood pressure dropped, and she was diagnosed with hypotension. What are the correct codes and POA assignments?
- Q13.4-Y, I95.9-N
- Q13.4-N, I95.9-Y
- Q13.4-Y, I95.0-N
- Q13.4-Y, I95.0-1
The correct codes and POA statuses for congenital keratoconus and hypotension are Q13.4-Y and I95.9-N. Q13.4-Y: Index>keratoconus>congenital. POA indicator Y is appended to identify a condition that was present upon admission. I95.9-N: Index>hypotension. POA indicator N is appended to identify a condition that was not present upon admission.
Congenital: A condition existing at the time of birth.
Billy Baker was admitted with pneumococcal sepsis and iron deficiency anemia. What are the correct codes and POA assignments?
- A40.0-Y, D50.9-Y
- A40.1-Y, D64.9-Y
- A40.3-Y, D50.9-Y
- A40.8-Y, D64.9-Y
A40.3-Y and D50.9-Y are the correct codes and POA assignments for pneumococcal sepsis and iron deficiency anemia. A40.3-Y: Index>sepsis>pneumococcal. POA indicator Y is appended to identify a condition that was present upon admission. D50.9-Y: Index>anemia>deficiency>iron. POA indicator Y is appended to identify a condition that was present upon admission.
Sepsis: Condition typified by two or more systemic responses to infection; a specified pathogen.
Sandy Summitt delivered a healthy female live-born infant without any complications. What are the correct codes and POA assignments?
- O80-1, Z37.0-1
- O80-Y, Z37.0-Y
- O82-1, Z37.0-1
- O82-Y, Z37.0-Y
O80-1 and Z37.0-1 are the correct codes and POA for a normal delivery of a single live-born infant. O80-1: Index>delivery>normal. POA indicator 1 would be appended to identity a condition that is exempt from POA reporting. Z37.0-1: Index>outcome>single>live-born. POA indicator 1 would be appended to identity a condition that is exempt from POA reporting.
Complication: An unexpected illness or other condition that develops as a result of a procedure, service, or treatment provided during the patient’s hospital stay.
In an inpatient setting, if documentation is insufficient to determine whether the condition was present on admission, which POA indicator will the coder assign?
- U
- W
- N
- Y
The coder will assign the POA indicator U for a condition that was not sufficiently documented to determine whether it was present upon admission.
Condition: A health-related situation.
Carolyn Crimson was admitted for acute appendicitis. The day after surgery, she had a hemorrhage and hematoma and was taken back to surgery. Which is the correct POA assignment for this case?
- K35.80-Y, K91.840-N
- K35.80-N, K91.841-N
- K35.80-Y, K91.840-Y
- K35.80-Y, K91.841-N
K35.80-Y, K91.840-N is the correct code assignment. The appendicitis is coded as Y because it was present on admission. The post-op hemorrhage is N because it developed after admission. K35.80-Y: Index>appendicitis>acute. POA indicator Y is appended to identify a condition that was present upon admission. K91.840-N: Index>complication>postprocedural>hemorrhage>digestive system>following procedure on digestive system. POA indicator N is appended to identify a condition that was not present upon admission.
Acute: Severe; serious.
Which of the following is also called a nosocomial condition?
- Complication
- Co-morbidity
- Major complication or co-morbidity
- Hospital-acquired condition
A hospital-acquired condition is also called a nosocomial condition.
Hospital-acquired Conditions (HAC): A condition, illness, or injury contracted by the patient during his or her stay in an acute care facility; also known as a nosocomial condition.
Which of the following is HAC data used for?
- Evaluating patient safety directives
- Limiting payment to a facility for errors
- Both evaluating patient safety directives and limiting payment to a facility for errors
- Neither evaluating patient safety directives nor limiting payment to a facility for errors
a facility for errors HAC data are used for both evaluating patient safety directives and limiting payment to a facility for errors.
Hospital-acquired Conditions (HAC): A condition, illness, or injury contracted by the patient during his or her stay in an acute care facility; also known as a nosocomial condition.
What does the abbreviation HAC stand for?
- Hospital admission criteria
- Hospital-acquired condition
- Hospital-acute condition
- Hospital-associated condition
The abbreviation HAC stands for hospital-acquired condition.
Hospital-acquired Conditions (HAC): A condition, illness, or injury contracted by the patient during his or her stay in an acute care facility; also known as a nosocomial condition.
What does the abbreviation POA stand for?
- Persistent on admission
- Present on admission
- Permitted on admission
- Painful on admission
The abbreviation POA stands for present on admission.
Present On Admission (POA): A one-character indicator reporting the status of the diagnosis at the time the patient was admitted to the acute care facility.
In an inpatient setting, if a patient had a condition when he or she was admitted to the hospital, which POA indicator will the coder assign?
- U
- W
- N
- Y
The coder will assign the POA indicator Y for a condition that was present upon admission.
Condition: A health-related situation.
In an inpatient setting, if a patient did not have a condition when he or she was admitted to the hospital, which POA will the coder assign?
- U
- W
- N
- Y
The coder will assign the POA indicator N for a condition that was not present upon admission.
Condition: A health-related situation.
In an inpatient setting, if a condition is exempt from POA reporting, which POA indicator will the coder assign?
- 1
- W
- N
- Y
The coder will assign the POA indicator 1 for a condition that is exempt from POA reporting.
The UHDDS is a collection of specific data gathered about hospital patients:
- on admission.
- on discharge.
- before surgery.
- postoperatively.
The UHDDS is a collection of specific data gathered about hospital patients on discharge.
Uniform Hospital Discharge Data Set (UHDDS): A compilation of data collected by acute care facilities and other designated health care facilities.
Which of the following is part of the demographic information collected in the UHDDS?
- Age
- Gender
- Ethnicity
- All of these
Age, gender, and ethnicity are all collected in the UHDDS.
Other Specified: Additional information that the physician specified and isn’t included in any other code description.
Which of the following is NOT part of the clinical information collected in the UHDDS?
- Provider information
- Diagnoses
- Procedures
- External causes of injury
Provider information is part of the demographic data collected in the UHDDS.
What does the abbreviation LOS stand for?
- Length of stay
- Last office stay
- Length of standards
- Last outpatient stay
LOS stands for length of stay.
What does the abbreviation UHDDS stand for?
- U.S. Hospital Discharge Data Set
- Uniform Hospital Discharge Data Set
- Uniform Hospital Discharge Data Standards
- U.S. Hospital Discharge Data Standards
The abbreviation UHDDS stands for Uniform Hospital Discharge Data Set.
Uniform Hospital Discharge Data Set (UHDDS): A compilation of data collected by acute care facilities and other designated health care facilities.