Investigation Finds Medical Coders Excel at Present on Admissions Indicators

While it wasn’t quite a pat on the back, an investigation into coders for the nation’s healthcare providers  found them to collectively have relatively low error rates when it came to Present on Admissions (POA) indicators.

The Office of Inspector General in the U.S. Department of Health and Human Services investigated a random sample of Medicare claims and found an error rate of less than 3 percent related to POA indicators.

Furthermore, most of the errors that were found were unrelated to either the care the patient received or the compensation the provider got from Medicare.

“The 3-percent national POA indicator error rate is relatively low, particularly given that our review assessed claims submitted early in the implementation of the POA reporting requirement,” the Inspector General’s office writes. “However, POA indicators provide an opportunity for monitoring hospital quality of care and are critical to CMS’s efforts to link payment to quality; they must be accurate to serve these purposes. Encouraging hospitals to assess POA reporting practices related to developing conditions and exemption codes, and to retrain staff as needed, could help to ensure accuracy.”

Considering that the POA indicator code can be the difference between a provider getting paid or not paid by Medicare, one might see that there would be a temptation to code in such a way to ensure revenue. The Inspector General’s investigation found no such trend, and when it comes to POA indicators, it appears that coders are an ethical bunch.