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POA indicator and properly filling out claims

March 2, 2015

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As part of industry standards for claims processing, AmeriHealth enforces present on admission (POA) indicator billing requirements and claims processing policies for acute-care hospitals on our new operating platform. Claims processed on the new platform with dates of service on or after January 1, 2014, without a valid POA indicator (as applicable) will be rejected. All hospitals are required to follow instructions from the Centers for Medicare & Medicaid Services regarding identification of the POA for all diagnosis codes for inpatient claims submitted on the UB-04 and ASC X12N 837 Institutional (837I) forms.

However, it is important to note that number "1" is no longer valid on electronic claim submissions under the version 5010 format. The POA field should instead be left blank for codes exempt from POA reporting.

If you have any questions about the POA indicator, please contact your Network Coordinator or your Hospital/Ancillary Services Coordinator.

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