Home Health & Hospice Week

Welcome greater clarity, fewer items.

You have only a few short months to prepare for the OASIS-C1/ICD-9 implementation date of Jan. 1, and that’s with a few major holidays throwing a wrench in your training schedule. Make certain you know your way around the new data set before OASIS-C1 is upon you.

While the OASIS-C1 was originally conceived to help address the changes ICD-10 would bring to the OASIS diagnosis coding questions, many other items were changed during the development of the revised data set. So, even though ICD-10 has been put on hold, the move to OASIS-C1/ICD-9 is still set for Jan. 1, 2015.

What to expect: Changed items in the OASIS-C1/ICD-9 could be impacted in five different ways, said physical therapist Linda Krulish of Redmond, Wash.-based OASIS Answers during the Sept. 3 Centers for Medicare & Medicaid Ser-vices OASIS-C1 implementation webinar:

1. Some OASIS-C items were deleted.
2. Data collection for some items was dropped at various time points.
3. Some existing OASIS-C items were revised or refined.
4. Some existing OASIS-C items were replaced with new OASIS-C1/ICD-9 items.
5. Some existing OASIS-C items were split into two items.

Bid These Items Farewell

Get to know these OASIS-C items CMS is cutting from the OASIS-C1/ICD-9 dataset. Come Jan. 1, you’ll no longer see:

• M1012: Inpatient procedures. The coding of procedures has already been optional for the last three years, said nurse Sharon Litwin with 5 Star Consultants in Camdenton, Mo. Leaving this item behind is good, “especially as we go into ICD-10,” she said during the recent Eli-sponsored audioconference “OASIS-C Tips and Training.” Because there are so many ICD-10 procedure codes that require much more specific data than home health coders traditionally receive, this is one item most agencies won’t mind losing.

• M1310, M1312 and M1314: Pressure ulcer length, width and depth. These items were supposed to collect data about pressure ulcer improvement, but problems with data validity caused CMS to remove them from the OASIS-C1/ICD-9. But don’t stop measuring your patient’s pressure ulcers, Litwin advised. You’ll still want to do measurements as part of the assessment on a regular basis, but that data will no longer be reported on the OASIS, she said.

• M2440: Nursing Home Admission Rea-son. This data turns out to not be used for anything, so say good-bye to this confusing item.

Keep An Eye On These Time Point Changes

While CMS eliminated the above items altogether, it cut other items only at certain times. Items deleted only at some time points include:

• M1350: Skin lesion or open wound … receiving intervention from the home health agency. You’ll no long collect this item at follow-up or discharge. Watch for some changes to the Response-Specific Guidance for this item, including a listing of excluded wounds and lesions, as well as instructions for when it’s appropriate to select each response. Some agencies will choose to continue to keep this item on the recertification assessment, even though it’s no longer required, to act as a ‘gateway’ question for documenting other types of wounds, predicts attorney Lisa Selman-Holman with Selman-Holman & Associates and CoDR — Coding Done Right in Denton, Texas.

• M1410: Respiratory treatments utilized at home. No longer collected at discharge.

• M2110: How often does the patient receive ADL or IADL from any caregiver(s) (other than home health agency staff)? No longer collected at discharge. 

Note: See the OASIS-C1/ICD-9 data set at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQuality Inits/OASIS-C1.html and the OASIS-C1/ICD-9 Gui-dance Manual (06/14) at www.cms.gov/Medicare/ Quality-Initiatives-Patient-Assessment-Instruments/ HomeHealthQualityInits/HHQIOASISUserManual.html.