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




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