January 17, 2008

BC-08-01

Present on Admission (POA) Indicator Required By Blue Cross and Blue Shield of Kansas

Effective with inpatient discharges of April 1, 2008 and after, BCBSKS will require all hospital providers to appropriately code present on admission indicators as part of their inpatient claim and record. 

This BCBSKS requirement:

• Applies to all inpatient discharges of April 1, 2008 or after.
• Applies to all contracting and non-contracting hospital providers.
• Applies to all hospitals including critical access hospitals etc. that may be exempt from this requirement by other payers such as Medicare.
• Does not apply if Medicare is the primary payer. In this example, BCBSKS is secondary to Medicare and POA information would not be required.
• Applies to inpatient claims when another insurance company (not Medicare) is the primary payer. BCBSKS will require POA information on inpatient claims even if the primary payer did not require the information.   

The Centers for Medicare & Medicaid Services (CMS) has available a new Hospital-Acquired Conditions (HAC) and Present on Admission (POA) Indicator web page to provide reliable and timely information on this quality of care initiative http://www.cms.hhs.gov/HospitalAcqCond/01_Overview.asp#TopOfPage.  While this page offers information about the Medicare regulations, reporting, coding, and affected hospitals, it may also serve as a valuable source of information as providers implement this requirement for all healthcare payers.