CDI Essentials: Medical Record Review - Present on Admission, Hospital-Acquired Conditions, and Serious Reportable Events
About this courseThis course provides an introduction to present on admission (POA) status, hospital-acquired conditions, and serious reportable event requirements that may influence the clinical documentation integrity (CDI) process. Areas reviewed in relation to CDI include coding guidelines and tips to acquiring documentation from providers that will support accurate and complete POA and code selection.
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- Review present on admission (POA) status indicators, hospital-acquired conditions (HACs), and serious reportable events
- Explore documentation within the medical record to appropriately identify the POA status of various conditions
- Learn to recognize HACs and serious reportable events, and how they impact reimbursement and quality scores
- Examine specific condition examples and the documentation needed to determine the POA status
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