QI-Core Implementation Guide
4.1.1 - STU 4.1.1 US

This page is part of the Quality Improvement Core Framework (v4.1.1: STU 4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, 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/3.1.0/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/3.1.0/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/3.1.0/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/3.1.0/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/3.1.0/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></table></li></ul></div>
  </text>
  <url
       value="http://hl7.org/fhir/us/qicore/ValueSet/qicore-present-on-admission"/>
  <version value="4.1.1"/>
  <name value="QICorePresentOnAdmission"/>
  <title value="QICore Present On Admission Codes"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2021-05-14"/>
  <publisher value="http://www.hl7.org/Special/committees/cqi/index.cfm"/>
  <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>
    </include>
  </compose>
</ValueSet>