Updates on Hospital Acquired Conditions (HAC) and Never Events
Effective November 30, 2021, an updated Blue Cross Blue Shield North Carolina (Blue Cross NC) reimbursement policy will go into effect. Updates include the following:
- Facilities granted Centers for Medicare & Medicaid Services (CMS) exemption status, including, but not limited to, inpatient psychiatric hospitals, critical access hospitals, or other facilities will now also be subject to Present on Admission (POA), Hospital Acquired Conditions (HAC), and Never Event editing.
- Claim lines containing diagnoses or procedures with “N” or “U” POA indicators, indicating a condition was hospital acquired, will not be reimbursable.
These updates will apply to all provider types. For more information, view the revised reimbursement policy.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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