2027 ICD-10-CM POA Exempt Codes ICD-10-CM

Present on Admission indicators tell CMS whether each diagnosis on an inpatient claim existed when the patient was admitted. Exempt codes describe circumstances where that question has no meaning, such as sequelae of an earlier illness, congenital conditions, or the external cause of an injury, so hospitals do not assign an indicator for them.

The FY 2027 CMS exempt list contains 38,399 diagnosis codes across 87 code ranges, effective October 1, 2026 through September 30, 2027.

CMS uses the indicator for its hospital-acquired condition (HAC) policy. When a condition on the HAC list is reported with N (not present on admission) or U (documentation insufficient), it does not count as a CC or MCC when the MS-DRG is assigned, which can lower the payment for the stay. Exempt codes sit outside this logic entirely.

None: the POA field is left blank. The ICD-10-CM Official Guidelines (Appendix I) allow a blank POA field only for codes on the exempt list. Older claim formats used the value 1 (unreported, exempt) for these codes, but CMS discontinued 1 with the 5010 claim format in January 2011. Every other diagnosis takes Y (present), N (not present), U (unknown) or W (clinically undetermined).