A borderline pressure injury may be HAC-sensitive, and POA is unclear from the record. Which query approach is appropriate?

For a borderline pressure injury that may be HAC-sensitive with unclear POA at a county hospital, the appropriate query clarifies present-on-admission status from clinical indicators without pressuring the provider to avoid HAC-related language for payment or score reasons. Civic CDI and coding protect both accurate public measures and ethical provider communication. Querying the provider to document present on admission whenever HAC risk appears, regardless of clinical truth, is a leading, outcome-driven query. Instructing the provider in the query text to avoid wording that could trigger an HAC coaches documentation for the report card. Skipping the query and assigning POA U on every dermatologic finding to neutralize HAC logic abuses the unknown indicator and abandons clarification duties. Exam caveat: compliant queries seek clinical clarity; they do not steer POA or diagnosis wording to manage HAC rates. Operational check: present objective indicators (admission skin assessment, timing, staging notes), ask an open POA clarification, document the response, assign POA accordingly, and escalate any directive to coach HAC-avoidant language. Sustain civic accountability by pairing correct code assignment with transparent denial, quality, and privacy escalation paths so public reporting and payment integrity move together.