Patti: You have provided excerpts from the MLN Matter Number MM5499, and that's part of the problem. If you read the actual CMS Change Request # 5499 (and the more recent one which was just published on July 20 - CMG CR 5679, Transmittal 289), this states:
In I.A Background section: "Section 5001(c) of the Deficit Reduction Act of 2005 requires hospitals to begin reporting the secondary diagnoses that are present on the admission (POA) of patients effective for discharges on or after October 1, 2007."......."This instruction will require hospitals to begin reporting the POA code on claims with discharges beginning on or after October 1, 2007. Although hospitals must report the POA code on the claim, the information will not be used by claims processing systems until January 1, 2008." In, I.B Policy section: "In order to group diagnoses into the proper DRG, CMS needs to capture a PO indicator for all claims involving inpatient admissions to general acute care hospitals. Use the UB04 Data Specifications Manual....to facilitate the assignment of the POA indicator for each principal diagnosis and other diagnoses codes reported on claim forms UB-04 and 837 Institutional. The law requires that these POA indicators be reported on all claims for inpatient admissions to general acute care hospitals with discharge dates on or after October 1, 2007." Given that multiple CMS regs seems to contradict themselves, I believe it best to follow the actual CMS Change Request, and not the informational MLN Matters document, to determine what is required. So that's my dilemna. Gary J. Ring Strategic Resource Group, Inc. 11 Jones Road, Peabody, MA 01960 978-807-1573 -------------- Original message -------------- From: "Patti Markunas" <[EMAIL PROTECTED]> FYI ~ Below are exerpts from CMS Change Request #5549 I believe this is the information you are looking for.... "Effective October 1, 2007, Medicare will begin to accept a Present On Admission (POA) Indicator for every diagnosis on your inpatient acute care hospital claims. However, providers must submit the POA on hospital claims beginning with discharges on or after January 1, 2008." Beginning for discharges on or after October 1, 2007, hospitals should begin reporting the POA codes for acute care inpatient PPS discharges. There is one exception, i.e., claims submitted via direct data entry (DDE) should not report the POA codes until January 1, 2008, as the DDE screens will not be able to accommodate the codes until that date. Hope this helps !! ----- Original Message ----- From: Gary Ring To: [email protected] Sent: Monday, July 23, 2007 11:05 AM Subject: [MEDITECH-L] POA Indicators I, several of my clients, and Meditech are debating the required Implementation Date for including POA (Present On Admission) Indicators on claims. According to the CMS regs (Change Request CR-5499), POA Indicators are required on ALL claims effective 10/1/07. However, while the reg is clear on the timeline for including these indicators on the UB04, the reg is not entirely clear (or at least may contradict) when they need to be included on the 837 4010A1 electronic claim. It is our intepretation that they are also required on electronic claims effective 10/1/07, but Meditech is stating that they are not required until 1/1/08, and therefore will not ensure that the programming is for 10/1/07. If anyone else has reviewed this regulation, and can give us an opinion on your interpretation of the implementation date/timeline for UB04 and 837 electronic claims, we would appreciate it. Thanks. Gary J. Ring Strategic Resource Group, Inc. 11 Jones Road, Peabody, MA 01960 978-807-1573 =*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*= To subscribe or unsubscribe to the meditech-l, visit http://mtusers.com/mailman/listinfo/meditech-l_mtusers.com To check the status of the meditech-l, visit MTUsers.NET For help, email [EMAIL PROTECTED] Please visit and add information to the MTUsers WikiPedia at MTUsers.NET/mwiki ______________________________________ meditech-l mailing list [email protected] http://mtusers.com/mailman/listinfo/meditech-l_mtusers.com ***** CONFIDENTIALITY NOTICE ***** This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system.
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