Edit 02079


Missing or Invalid POA Code

HIPAA Claim Adjustment Reason Code: 125
    Remark Code: N434
HIPAA Healthcare Claim Status Code: F2
    Entity Identifier Code: N/A

Potential Causes:
POA (Present on Admission) is required on all Hospital Inpatient claims for each diagnosis. At least one diagnosis reported on the claim did not have POA reported, or the POA code that was entered is incorrect.

Solution:
Enter the correct POA code. The valid POA codes are N, Y, U, W, or 1. They are entered in the K3 File Information segment in data element K301, in the same order as the diagnosis codes. Refer to the 837 Institutional Companion Guide for the detailed specification.

837 Institutional

Loop 2300 HI (Principal, Admitting, E-code And Patient Reason for Visit Diagnosis Information) HI01-2 (Principal Diagnosis Code) - and - HI (Other Diagnosis Information) HI01-2 – HI12-2 (Other Diagnosis Code) - and - K3 (File Information) K301(Fixed Format Information)