Certified Inpatient Coding (CIC) Practice Exam

In the context of the Present On Admission (POA) indicators, the applicable answer when a patient's septic condition was unclear at admission is the indicator that reflects uncertainty. In this case, if sepsis developed due to pneumonia and it cannot be determined whether the sepsis was present at the time of admission, the proper code to use would indicate that the status of the condition was undetermined. The POA indicators are defined as follows: - 'Y' indicates that the condition was present at admission. - 'N' signifies that the condition was not present at admission. - 'U' means that the documentation is insufficient to determine whether the condition was present on admission. - 'W' is specifically used for circumstances where the documentation does not allow for a clear assessment of the patient's condition upon admission, particularly in complex cases where the status of a condition may only be recognized during the inpatient stay. In this scenario, using the appropriate indicator reflects the ambiguity surrounding the patient's condition during admission. The choice aligns with coding guidelines that emphasize the need for clarity in determining the presence of conditions to ensure accurate record-keeping and billing.