Home Health & Hospice Week

You might be surprised by which codes and forms to use when.

It’s time for counting down days instead of months until ICD-10 implementation. You’re bound to get confused about which form to use and which code set to report now that the crunch is on for ICD- 10 and OASIS-C1/ICD-10. Try these strategies from coding expert Lisa Selman-Holman of Selman-Holman & Associates, CoDR — Coding Done Right and Code Pro University in Denton, Texas, to help smooth the way.

Assessments Through September

For episodes beginning up to Sept. 30, you’ll use the OASIS-C1/ICD-9. You’ll report ICD- 9 codes on the RAP and ICD-10 codes on the claim, Selman-Holman says. To make it easier to complete the claim, consider listing the ICD-10 codes in plan of care item 21 or elsewhere so you can retrieve them at the appropriate time.

This applies for episodes beginning Aug. 3 through Sept. 24, Selman-Holman says. This includes start of care (SOC), recertifications and ROCs acting as recertifications.

SOC At End Of September

The M0090 date determines which OASIS you will complete. You have five days after the SOC to complete the OASIS.

For example: SOC is Sept. 28 but the assessment is completed Oct. 2 because the patient had a pressure ulcer covered by a non-removable dressing that the clinician wanted to assess. In this situation, you would complete the OASIS-C1/ICD- 10 using ICD-10 codes that will determine the HIPPS code, Selman-Holman says. But you’ll code the RAP with a ‘from’ date of Sept. 28 in ICD-9.

Strategy: In this situation, if possible, try to finish SOC by Sept. 30, so you can use the OASISC/ ICD-9 and ICD-9 codes for this patient, Selman- Holman suggests. Or go ahead with the OASIS C1/ICD-10 and figure out what ICD-9 codes you’ll need for the RAP.

 Recertification At End Of September

You must complete the OASIS within five days before the ‘from’ date on a recertification, Selman- Holman says. So, a recertification episode starting on Oct. 2 could have a M0090 date of Sept. 28. In this situation, you’ll use ICD-9 codes on the OASIS-C1/ICD-9 and ICD-10 codes on the RAP and claim.

Strategy: If possible, don’t do the recert assessment until Oct. 1, Selman-Holman suggests. Then you can use the OASIS-C1/ICD-10 and ICD-10 codes and you won’t have to re-code.

Resumption Of Care At End Of September

For ROC at the end of September, you’ll base your OASIS and code set selection on the M0090 date on the assessment. You have two days after discharge (or after knowledge of discharge) to complete the ROC assessment. Remember, a visit can be made prior to the ROC assessment, Selman- Holman says.

For example: Your patient comes home from the hospital on Mon. Sept. 29. A Licensed Vocational Nurse makes a visit on Tues. Sept. 30. The RN completes ROC assessment on Wed. Oct. 1.

Strategy: If you complete the OASISC1/ ICD-10 in October, you can use ICD-10 codes, Selman-Holman says. That means your coding is already mostly done for the final claim.

Note: For more information on ICD-10 and OASIS, subscribe to Eli’s Home Health Coding & OASIS Expert at https://www.aapc.com/codes/.