HAC - Hospital Acquired Conditions & POA - Present on Admission

This option is available to Advanced subscribers only.

Watch a short YouTube movie and see how easy it is to find the correct HAC and POA with ICD10Doc.

Note CMS has recently released the HAC lists with ICD-10 Diagnosis and Procedures codes. Thus, ICD10Doc application uses the crosswalk / mapping to and from HAC using ONLY the ICD-10 set of codes and none of the ICD-9 codes.

1. You can search for a HAC using the free-text search from the landing page or using the HAC number and the reverse search functionality.
On the intial results page, in the HAC box - you can click on the HAC link that interests you and ICD10Doc will take you to the HAC details page.





On the HAC details page, you can review the ICD-10 Diagnosis and Procedures that are related to this HAC and whether the code is part of the POA - Present on Admission list.



2. When reviewing an ICD-10 code (Diagnosis or Procedure) that interests you, in the HAC related information box, you may see HAC related links to those hospital acquire conditions that include the diagnosis / procedure in their definition of a HAC.





See below details on the various parameters related to HAC.

Background

HAC and POA try to identify conditions that:
1. Are high cost or high volume or both
2. Result in the assignment of a case to an MS-DRG that has a higher payment when present as a secondary diagnosis; and
3. Could reasonably have been prevented through the application of evidence-based guidelines.
For discharges occurring on or after October 1, 2007, IPPS hospitals do NOT receive the higher payment for cases when one of the selected conditions is acquired during hospitalization.

There are 16 HACs:
1 Foreign object retained after surgery - secondary diagnosis
2 Air embolism - secondary diagnosis
3 Blood incompatibility - secondary diagnosis
4 Stage III and IV pressure ulcers - secondary diagnosis
5 Falls and trauma - secondary diagnosis
6 Catheter-associated urinary tract infection - secondary diagnosis
7 Vascular catheter-associated infection - secondary diagnosis
8 Surgical site infection-mediastinitis after coronary bypass graft
9 Manifestations of poor glycemic control - secondary diagnosis
10 Deep Vein Thrombosis / Pulmonary Embolism with total knee or hip replacement
11 Surgical site infection - bariatric surgery
12 Surgical site infection - certain orthopedic procedures of spine, shoulder and elbow
13 Surgical site infection following cardiac implantable electronic device procedures
14 Iatrogenic pneumothorax with venous catheterization
15 Primary diagnosis is considered MCC
16 Primary diagnosis is considered CC

All of the above HAC will have one or more ICD-10 Diagnosis and the Complication / Comorbidity or Major Complication / Comorbidity related.
Some will have ICD-10 Procedures related to the HAC. When procedures are related, it is the combination of a Diagnosis and a Procedure that defines the HAC.
In addition to the above - CMS has published specific instructions regarding POA - Present On Admission, how to document these POA in order to prevent reduction in payments due to HAC. ICD10Doc presents information on each ICD-10 code - whether it is part of a HAC definition and / or POA.

For more information on HAC visit CMS web site
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