This section contains links to published work and other materials that define the POA indicator, explain POA coding and reporting requirements, and describe the benefits of enhancing administrative datasets with POA indicators.

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Pilot and Planning Projects: AHRQ-funded pilot and planning project descriptions with access to materials.

Overview Publications

• The Case for the Present-on-Admission (POA) Indicator (PDF file, 246 KB), This 2006 HCUP Methods Report provides an overview of the POA indicator, as well as references to literature on the value of POA, including:
• Supporting views for the use of the POA indicator cited in health policy research literature,
• Evidence showing the impact that POA would have on research and policymaking, and
• Efforts that should be undertaken to enhance POA coding accuracy.


• The Case for the Present-on-Admission (POA) Indicator: Update 2011 (PDF file, 323 KB). This 2011 HCUP Methods Report provides POA-related information and developments that have occurred over the past five years, including UB data reporting standards for the POA indicator, CMS requirements for POA reporting, and implementation of the POA indicator in software. The report also includes an updated literature review that covers:
• The value of the POA indicator in hospital quality measurement
• Use of POA to assess potential hospital reimbursement policies
• Issues and challenges of accurate POA coding

Articles

• Identifying Potentially Preventable Complications Using a Present on Admission Indicator (Hughes et al, 2006 Health Care Financing Review)

Other Resources

• Hospital-Acquired Conditions (Present on Admission Indicator) Overview (Centers for Medicare and Medicaid Services)



• Present on Admission (POA) Indicator Reporting by Acute Inpatient Prospective Payment System (IPPS) Hospitals (Centers for Medicare and Medicaid Services, October 2010)



• ICD-9-CM Official Guidelines for POA Coding and Reporting (refer to Appendix I, page 95 for guidelines on coding and reporting POA on the UB-04 and 837 claim forms)


• Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care-Acquired Conditions (Final Rule) (Centers for Medicare and Medicaid Services, 2011). CMS expands non-payment to the Medicaid program for Provider-Preventable Conditions (PPC), including Health Care-Acquired Conditions (HCAC) and Other Provider - Preventable Conditions (OPPC) extending beyond inpatient to the outpatient setting. The rule requires providers to self-report HCACs through claim systems and allows states flexibility with how to verify PPCs, whether through existing POA systems or another method.