Why is the Present-on-Admission Flag Important?
(Part 2 of 3)

The Present-on-Admission (POA) indicator is a flag assigned to each diagnosis code on inpatient claims. Until recently, the Texas Health Care Information Council (THCIC) had not required hospitals to submit the POA indicator in order to allow time for transitioning and establishing processes for coding accurately.

THCIC will require the POA flag in all inpatient claims starting with January 2011 discharges. The POA flag is not required for outpatient data.

Increasingly, administrative billing data is being used for measuring hospital performance and for public reporting. Key reasons why it is important to comply and submit POA include:

• Distinguish between pre-existing conditions and complications;
• Improve reporting accuracy of hospital data distributed to consumers;
• Increase validity of hospital report cards related to quality of care;
• Improve the accuracy of results in mortality risk assessment and outcomes research;
• Reduce the number of false positives in identifying cases for further quality assurance reviews.

Many data elements used to identify risk of complications and existing diagnosis during a patient’s admission are critical when comparing quality indicators across hospitals.