Reference no: EM133868333

Question

Develop an Audit Plan: The Hospital-Acquired Conditions Present on Admission (POA) Program designates diagnosis and procedures that are considered preventable in the inpatient setting. One condition identified by CMS includes Stage III and Stage IV pressure ulcers (ICD-10-CM codes in category L89). To indicate whether the pressure ulcer was present when the patient was admitted or was acquired during the hospital stay, the hospital must report a present on admission code for L89.- diagnosis codes on the claim form. Hospitals with HACs may have reimbursement for the admission decreased. Scenario: You are the coding manager at Happy Hospital. It is the responsibility of the coding specialists to assign the POA indicator code. You have collected data over the past six months for stage III and stage IV pressure ulcers. It is quite clear from the data shown below that there is an issue with either the documentation of pressure ulcers, assignment of the POA indicator, or the quality of care provided at Happy Hospital. 530-159 HAC and POA.JPG Design an audit plan (not an audit tool) for this issue. When designing your audit plan consider the following questions to help you determine components that should be incorporated.