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.