Saturday, December 13, 2008

Present on Admission (POA) for Institutional Medical Claims (UB-04)

Starting December 30, 2008 RelayHealth medical claims clearinghouse will print the Present on Admission (POA) indicator for institutional paper claims that are submitted through RelayHealth (electronic file sent to RelayHealth and RelayHealth drops claim to paper).

CMS was the first to require the POA but RelayHealth wants to open this up and make it available for institutional medical claims to submit these to other insurance carriers as needed.

When dropping Institutional Claims to Paper through RelayHealth please use these CPID#'s:
4350 ~ Commercial
4352 ~ Medicaid
4353 ~ Blue Shield
4354 ~ Commercial Carrier Direct

Reporting Options to indicate POA (Present on Admission)
Y = Yes, was present at the time of inpatient admission
N = No, was not present at the time of inpatient admission
U = Unknown, documentation is insufficient to determine if condition is present on admission
W = Clinically undetermined provider is unable to clinically determine whether condition was present on admission or not
Unreported/Not used (exempt from POA reporting)

Medical Billing Tag Words: Medical Billing Health Insurance Claims, Medical Billing Hospital Facilities, Medical billing and Coding, Medical Billing and Collections, Coding, Reporting, Present on Admission, POA, ICD-9 codes, when to use POA, updates to POA

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