“Present on Admission” (POA) indicators for Medicare/Medicaid cases come as a result of the Deficit Reduction Act of 2005. Conditions which cannot be proven as present on admission will not be reimbursed. There are 12 now with more to be added, and includes such things as serious “reasonably preventable events”, catheter-associated urinary tract infection, pressure ulcers, and vascular catheter associated infection.
It will take a joint effort between providers and coders to insure appropriate documentation. Concurrent reviews with a problem list on the chart are used to communicate. The only way to prove that a condition was “present on admission” is for the provider to document it, so providers need to respond to these problem lists. Especially in the case of pressure ulcers, providers may not know about them unless they pay attention to the problem list or nursing notes.
This will directly affect hospitals October 1 and providers indirectly, but will eventually affect reimbursement for practitioners as well. It is expected that commercial payors will follow Medicare’s lead.