• Assign Y for any condition that develops during OP encounter prior to written order for IP admission.
• Combination codes: identify both the chronic condition & the acute exacerbation; see POA guidelines pertaining to combination codes. Assign Y if the combination code only identifies the chronic condition & not the acute exacerbation (e.g. acute exacerbation of CHF).
• Assign Y, if the final dx contains a Possible, Probable, Suspected, R/O dx & this dx was suspected at time of admission.
• Assign Y, if the final dx contains a Possible, Probable, Suspected, R/O dx & this dx was based on symptoms or clinical findings that were not POA.
• Over 250 dx are not applicable to POA reporting, such as obstetrical dx.

Every newspaper, every magazine is discussing quality. For example, one USA Today headline stated, “Hospitals too Slow on Heart Attacks; Study Finds only 35% Hospitals React Quickly Enough”. And, in the 2006 State of the Union address, President Bush called for an intense focus on improving the quality of healthcare, as well as pay for performance (P4P).

POA coding can reduce instances where hospitals are blamed for poor quality of care and when reported correctly, POA can answer these important questions: is the infection the result of a quality factor at the hospital? Or, was the dx present prior to admission? Many hospitals have been blamed for decubitus ulcers (bed sores) & other common dx.

Today, hospitals are restructuring payment systems accommodating for P4P by reducing or eliminating patient payments. Make sure your staff is up to date on POA coding guidelines and improve your hospital’s pay for performance, today.

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