Present On Admission (POA) Flags

Starting with version 33 and ICD10 support, diagnosis codes are supposed to have Present On Admission (POA) flags.

(Unless the institution or patient encounter is "exempt" which would be indicated by the POA Logic Indicator which we call "the exempt flag." The POA Logic Indicator gets its own post to keep confusion to a minimum.)

Here are the CMS definitions of the legal values for this single character flag:

Flag	Meaning
Y	Yes, present at the time of inpatient admission
N	No, not present at the time of inpatient admission
U	Insufficient documentation to determine if present on admission
W	Clinically unable to determine if present at time of admission
1	Code is exempt from POA reporting (Used on 4010 form)
Blank	Code is exempt from POA reporting (Used on 5010 form, effective 01/01/2011)

Many of our APIs have a "Have POA" flag which is something different: the "Have POA" flag is a record-level indication of whether or not there are POA flags in the submitted diagnosis data. The "Have POA" flag is either "y" for yes or "n" for no.

The POA flags are single-character fields at the individual diagnosis code level. There are up to 25 diagnosis codes accepted for DRG assignment and if you are using POA flags, every code should have one.

In their test data set,CMS passes the POA flag to its grouper as the last character of a fixed-width field. We support that methodology in our DRGFilt product's fixed-with mode and in our C-callable DLL as these are environments in which appending an indicator is relatively easy.

We also support passing in separate POA flag fields in our DRGFilt product's CSV mode and in our VB-callable DLL as there environments generally have better support for separate fields than for character manipulation.