Home Health & Hospice Week

Don't let revamped guidelines cause confusion.

To help your staff get to know the feds' new OASIS guidance, keep this overview of revised items handy.

Tip: Many items haven't been changed. Rather, the Centers for Medicare & Medicaid Services is clarifying how items in the list below should be coded.

• M0060 (Zip code). CMS reminds agencies to supply patients' zip codes for Home Health Compare.

• M0063 (Medicare number). Don't enter an HMO identification number here. CMS gives additional guidance: "If the patient is a member of Medicare, another Medicare Advantage plan, or Medicare Part C, enter the Medicare number if available." If the number is not available, mark "NA - No Medicare."

• M0080 (Discipline of person completing assessment). Remember: The following groups aren't authorized to complete the comprehensive assessment: licensed practical nurses (LPNs), physical therapist assistants, certified occupational therapy assistants, medical social workers and home health aides.

• M0100 (Reason for assessment). CMS reminds providers to indicate Response 1 whenever an initial HIPPS code is needed for a home health resource group, whether or not the patient will be receiving ongoing services.

• M0150 (Current payment source). This item now expressly limits the payment source(s) selected to those paying for services included on the plan of care that you will bill.

• M0200 (Medical treatment change). Note that a physician appointment alone or a referral for home health services does not qualify as a medial treatment regimen change. In addition, remember that any change falling on the day of the assessment does not fall within the 14-day period.

• M0230/240 and M0254 (Diagnoses). The secondary diagnosis includes "all conditions that co-existed at the time the plan of care was established, or developed subsequently, or affect the treatment of care," reminds CMS. Such conditions should include not only those actively addressed in the plan of care but also any co-morbidity affecting the patent's responsiveness to treatment and prognosis. 

Red flag: CMS erroneously included a "severity rating" for this item. Home health agencies and software vendors should ignore the severity ratings when implementing other Chapter 8 changes.

• M0250 (Therapies). Be careful when considering Response 1, In Intravenous or Infusion Therapy. A new instruction advises home health agencies not to select that response if there are orders for an IV infusion to be given when specific parameters are present but the parameters are not met on the day of the assessment. Response 1 is also inappropriate if the patient is receiving peritoneal dialysis or home dialysis.

• M0420 (Pain frequency). Note this new definition: Pain interfering with activity is described in detail as pain "that results in activities being performed less often than desired, results in the need for additional assistance, or results in taking more time to complete."

• M0430 [...]