QI-Core Implementation Guide
6.0.0 - STU6 United States of America flag

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

: QICore Present On Admission Codes - XML Representation

Draft as of 2021-05-14

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="qicore-present-on-admission"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/shareablevalueset"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Include these codes as defined in <a href="http://terminology.hl7.org/5.0.0/CodeSystem-presentOnAdmission.html"><code>https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-presentOnAdmission.html#presentOnAdmission-Y">Y</a></td><td>Yes</td><td>Diagnosis was present at time of inpatient admission. CMS will pay the CC/MCC DRG for those selected HACs that are coded as &quot;Y&quot; for the POA Indicator.</td></tr><tr><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-presentOnAdmission.html#presentOnAdmission-N">N</a></td><td>No</td><td>Diagnosis was not present at time of inpatient admission. CMS will not pay the CC/MCC DRG for those selected HACs that are coded as &quot;N&quot; for the POA Indicator.</td></tr><tr><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-presentOnAdmission.html#presentOnAdmission-U">U</a></td><td>Unknown</td><td>Documentation insufficient to determine if the condition was present at the time of inpatient admission. CMS will not pay the CC/MCC DRG for those selected HACs that are coded as &quot;U&quot; for the POA Indicator.</td></tr><tr><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-presentOnAdmission.html#presentOnAdmission-W">W</a></td><td>Undetermined</td><td>Clinically undetermined.  Provider unable to clinically determine whether the condition was present at the time of inpatient admission. CMS will pay the CC/MCC DRG for those selected HACs that are coded as &quot;W&quot; for the POA Indicator.</td></tr><tr><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-presentOnAdmission.html#presentOnAdmission-1">1</a></td><td>Unreported</td><td>Unreported/Not used.  Exempt from POA reporting.  This code is equivalent to a blank on the UB-04, however; it was determined that blanks are undesirable when submitting this data via the 4010A. CMS will not pay the CC/MCC DRG for those selected HACs that are coded as &quot;1&quot; for the POA Indicator. The “1” POA Indicator should not be applied to any codes on the HAC list.  For a complete list of codes on the POA exempt list, see  the Official Coding Guidelines for ICD-10-CM.</td></tr></table></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cqi"/>
  </extension>
  <url
       value="http://hl7.org/fhir/us/qicore/ValueSet/qicore-present-on-admission"/>
  <version value="6.0.0"/>
  <name value="QICorePresentOnAdmission"/>
  <title value="QICore Present On Admission Codes"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2021-05-14"/>
  <publisher value="HL7 International / Clinical Quality Information"/>
  <contact>
    <name value="Clinical Quality Information WG"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description value="Value Set for QICore Present On Admission."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <compose>
    <include>
      <system
              value="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding"/>
      <concept>
        <code value="Y"/>
        <display value="Yes"/>
      </concept>
      <concept>
        <code value="N"/>
        <display value="No"/>
      </concept>
      <concept>
        <code value="U"/>
        <display value="Unknown"/>
      </concept>
      <concept>
        <code value="W"/>
        <display value="Undetermined"/>
      </concept>
      <concept>
        <code value="1"/>
        <display value="Unreported"/>
      </concept>
    </include>
  </compose>
</ValueSet>