Auditing "Present on Admission" Coding

Why Should You Attend:

The Deficit Reduction Act mandated financial incentives to reduce hospital acquired conditions which are identified through reporting Present on Admission (POA) indicators. Hospitals do not receive additional payment for Medicare cases in which a selected condition was not present on admission. As a result it is essential that hospitals employ a set of internal controls to ensure the proper and accurate reporting of POA codes on all inpatient claims to Medicare to avoid financial and compliance risks.

To help participants understand the framework for compliance under this act and its extensions, this training program will focus on conducting efficient POA audits, reviewing compliance implications in case of inaccurate POA reporting, and discussing best practices for POA identification.

Areas Covered in the Webinar:

1. Learn how to conduct a POA audit.
2. Review of compliance implications due to inaccurate POA reporting.
3. Learn specific control risks associated with this area of coding compliance.
4. Discuss best practices for POA identification and reporting.

Who Will Benefit:

This webinar will provide valuable assistance to any inpatient care provider who submits claims to the Medicare program. Workforce personnel who should attend include:

• Internal auditors
• Compliance officers
• CFOs/controllers
• HIM directors
• Consultants

Instructor Profile:

Kevin McPoyle, CPA, is the director of internal audit and compliance with Kennedy Health System in New Jersey. He is a healthcare audit and compliance specialist with over 20 years’ experience assisting healthcare providers, both large and small, with developing systems to ensure compliance, revenue integrity, and operational efficiency.

Mr. McPoyle has presented at numerous conferences and seminars and he is the past president of the Metropolitan Philadelphia Chapter of the Healthcare Financial Management Association where he led extensive efforts to design and deliver exceptional professional education for the industry.

Topic Background:

Medicare’s Value Based Purchasing program implemented as part of the Deficit Reduction Act mandates the reporting of POA indicators on all Medicare claims for inpatient services. The POA indicator is intended to differentiate conditions present at the time of admission from those conditions that are considered Hospital Acquired Conditions (HAC) and while some HACs may be unavoidable, the persistence of a high percentage of patients with HACs is considered an indicator of poor quality of care.

Due to these requirements and the impact that POA indicators can have on reimbursement, it is essential that hospitals have good procedures and controls in place that ensure that POA indicators are accurately reported on claims. Failure to report POA indicators can result in claims being rejected. Failure to report POA indicators accurately can result in hospitals being under or over paid.

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