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Data Element
CLT040
CLT.002.040
No Updates
Definition | A code to identify conditions that are present at the time the order for inpatient admission occurs; conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery. POA indicator is used to identify certain preventable conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a Diagnosis Related Group (DRG)* that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence-based guidelines. *States that do not use the grouper methodology may use CMS-approved methodology that is prospective in nature. Each Diagnosis Code Flag is associated with one, and only one, Diagnosis Code in a given file segment record. For example, Diagnosis Code n is associated with Diagnosis Code Flag n, where n can be any integer greater than or equal to 1. |
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Size | X(1) |
FLF Start Position | 203 |
FLF Stop Position | 203 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be in Diagnosis POA Flag List (VVL) 2. Value must be 1 character 3. Conditional |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
---|---|---|---|---|
CIP043 | CIP.002.043 | DIAGNOSIS-POA-FLAG-4 | CIP00002 | CLAIM-HEADER-RECORD-IP |