Wiki POA Indicator....need inpatient coder assistance

[meghanladue@gmail.com]

Hi, I had a colleague ask me an inpatient coding question, and I am NOT the person to ask, so I figured I'd share the question here. Any insights would be so appreciated!

Patient is admitted to hospital for stroke and seems stable for discharge to inpatient rehab. On arrival at rehab facility is febrile and has cough so sent directly to ED of hospital that cared for the patient initially. Patient found to have an aspiration pneumonia and is readmitted within 24 hours of discharge. The aspiration pneumonia clearly began during the first hospitalization (hospital acquired condition) so the claims for the two hospitalizations will be combined. What POA indicator should be appended to the diagnosis of aspiration pneumonia?

 

[Jjventin]

If the two admissions are being billed as one, I believe that the POA would be 'N' since the aspiration pneumonia wasn't present at the time of the initial admission.

 

[SaipradeeP]

Please refer the aspiration pneumonia indicators on the first admission notes, if they are developed after admission then you can select the POA indicator N. In some cases when patient had a stroke sometimes patient will have aspiration event but it will be diagnosed once the patient developed correlated symptoms. So please review the initial admission notes to find out any such information is available or not. Based on the information you can choose the appropriate POA indicator. But as per the information which you have provide it will be considered as POA N.