AHA Coding Clinic® for ICD-9 - 2013 Issue 1; Frequently Asked POA Questions
POA for Chronic Kidney Disease, Stage 3, Progressing to End Stage Renal Disease
The patient was admitted with acute respiratory failure, acute kidney injury due to acute tubular necrosis and chronic kidney disease, stage 3. The patient had a prolonged hospitalization and during the hospital course, he advanced to end stage renal disease (ESRD) and was started on hemodialysis. The provider stated, “Concerning possible renal recovery, it appears unlikely he will ever be dialysis independent given his history of CKD prior to his acute on chronic kidney injury and also because he is almost three months from his initial renal insult with no signs of renal recovery.” Since the chronic kidney disease, stage 3 had progressed to ESRD, requiring dialysis, what is the appropriate present on admission (POA) indicator for the ESRD? ...
Subscribe or sign in to view the full article.
Article Overview
This article addresses a inpatient coding and POA scenario involving chronic kidney disease that worsens during the hospital stay and later becomes end stage renal disease with dialysis. It is aimed at coders, CDI professionals, auditors, and billing staff who need to understand how to think about POA reporting when a condition evolves over the course of an admission. The discussion focuses on the POA indicator decision framework and related renal diagnosis considerations without presenting a broad clinical review.
Why This Topic Matters
POA reporting affects inpatient coding accuracy, quality reporting, and downstream data use. Articles like this help teams recognize how to handle conditions that deteriorate during admission when multiple related renal diagnoses may be involved.
What You Will Learn
- How POA concepts apply when a renal condition worsens during an inpatient stay.
- How chronic kidney disease progression is discussed in relation to end stage renal disease.
- How dialysis initiation factors into a POA reporting scenario.
- How inpatient coding staff interpret a deterioration-versus-new-condition situation.
Who Should Read This
- Inpatient coders
- Clinical documentation integrity specialists
- Coding auditors
- Hospital billing staff
- Health information management professionals
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com