Appendix Table 3.

Use of Present-on-admission (POA) Indicator to Identify Hospital-acquired Conditions

POA indicator coding	Meaning of this code	Payment decision by CMS for conditions listed with this POA status
Y	Diagnosis was present at time of inpatient admission.
W	Clinically undetermined. Provider unable to clinically determine whether the condition was present at the time of inpatient admission.	CMS will pay the CC/MCC DRG for those selected HACs that are coded as Y or W for the POA Indicator.
N	Diagnosis was not present at time of inpatient admission.
U	Documentation insufficient to determine if the condition was present at the time of inpatient admission.	CMS will not pay the CC/MCC DRG for those selected HACs that are coded as N or U for the POA Indicator.
1	This is listed for certain diagnoses for which hospitals are not required to list the present-on-admission status.	Exempt from POA reporting, does not alter Medicare payment.

Note: Details regarding POA coding transitions and edits were accounted for during the analysis, such as how exempt coding was handled each year for Michigan. Invalid coding for UTIs included missing, exempt, and any other coded value beyond the accepted valid codes of N, Y, W, or U.