Claim Form Rule - Managing Diagnoses Present on Admission Flags

  • Updated

What claim change is needed?

Manage the diagnoses "present on admission" (POA) flags for diagnosis codes. 


Diagnoses code POA flags options are below:

  • Y - Yes
  • N - No
  • W - Clinically Undetermined
  • U - Unknown

Box Number

UB-04: Box 67a-q - ICD-10 Diagnosis Codes

CMS-1500: n/a


  1. Navigate to Management Center > Claim Rules
  2. Click "Create Claim Form Rule".
  3. Select the practice.
  4. Name the claim rule.
  5. Set Claim Type to "Institutional".
  6. Set Conditions for claim rule to meet.
  7. Under Available Behaviors, select "Diagnoses - Present on Admission flags". mceclip2.png
  8. Click Add. 
  9. Select "Always Yes" to always show a "Y" for the claim rule conditions.

    Or, select "Use Patient Profile" to use the diagnosis POA flags from the Patient > Intake > Behavioral Service Diagnoses tab.
  10. Click Create.

Related Articles

Add Diagnoses Codes

To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.

To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.

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