The POA medical abbreviation most often means present on admission, a label showing that a diagnosis or condition already existed when a patient was admitted to the hospital. Coders, nurses and doctors use it so the record shows which problems came in with the patient and which developed during the stay.
POA has a second common meaning in health care: power of attorney, the person legally chosen to make decisions for someone else. Context tells them apart. A POA beside a diagnosis or wound points to admission status; a POA in the contacts or consent section points to a person. This page covers both.
At a glance
Stands for
Present on admission (most common in charts)Other meanings
Power of attorney, including health care power of attorneyIndicator values
Y, N, U, W, or blank for exempt codesUsed in
Inpatient coding, wound and skin assessments, admission notesRelated terms
Specialty
Health information, coding, nursing, case management
What the POA medical abbreviation means for a diagnosis
Present on admission means the condition existed at the time the order for inpatient admission was written. That includes problems diagnosed before admission, problems found in the emergency department before the admission order, and problems clearly developing at the time even if they are diagnosed later.
Hospitals report a POA indicator for diagnoses on inpatient claims in the US. Medicare uses it to separate conditions a patient arrived with from certain conditions acquired in the hospital, such as some pressure injuries, falls with injury and catheter related infections. For selected hospital acquired conditions not present on admission, the hospital does not receive the higher payment that the condition would otherwise bring.
POA indicator values and what they mean
| Indicator | Meaning |
|---|---|
| Y | Yes, present at the time of inpatient admission |
| N | No, developed after admission |
| U | Unknown, documentation is not enough to decide |
| W | Clinically undetermined, the provider cannot tell |
| Blank | The code is exempt from POA reporting |
Coders cannot guess. When the record is unclear, they send a query to the doctor asking whether a condition was present at admission. Clear documentation in the admission H and P avoids many of those queries.
POA in nursing skin and wound checks
Nurses play a direct part. On admission they do a full skin check and record any pressure injury, wound, bruise or device marks, often with photos. Those findings are labeled POA so nobody later assumes the injury began in the hospital.
Admission skin note: "Stage 2 pressure injury, sacrum, 2 x 3 cm, POA: Y." The wound was present when the patient arrived. If the same wound had first been found on day four, it would be recorded as not present on admission, and the care team would review what happened.
Falls, catheter infections and blood clots follow the same logic, which is why admission assessments are detailed.
POA as power of attorney
Outside coding, POA often means power of attorney, a legal document naming someone to act for another person. In health care the relevant type is a health care power of attorney, also called a health care proxy or agent in some states. That person can make medical decisions if the patient cannot speak for themselves.
In a chart it appears in contacts, consent or advance directive sections, as in "daughter is POA, copy on file." A financial power of attorney does not automatically grant health care decision rights. Questions about legal forms are best taken to the hospital's social worker or a lawyer.
Telling the two meanings apart
Look at what POA is attached to. Beside a diagnosis, a code, a wound or the letters Y or N, it means present on admission. Beside a person's name or a phone number, it means power of attorney. A note such as "wife, HCPOA" adds HC for health care to remove doubt.
For more admission and records shorthand, see the chart notes and nursing hub, and the DNR page for another advance care term that often appears near a POA entry.
These are general explanations of coding and legal terms. Your hospital's coding team, social worker or care manager can explain how either one applies to a specific stay.
Frequently asked questions
What does POA mean on a hospital diagnosis?
It means present on admission. The condition was already there when the inpatient admission order was written.
What does POA N mean?
It means the condition was not present on admission and developed during the hospital stay. Certain of these conditions are tracked as hospital acquired.
What does POA mean in a patient's contact list?
There it usually means power of attorney, the person the patient chose to make decisions for them. For medical decisions, the document needs to cover health care.
Who decides whether a condition was present on admission?
The treating provider documents it, and coders assign the indicator from that documentation. If the record is unclear, coders send the provider a query.