Home Health ICD-9/ICD-10 Alert

Don't change your forms yet.

If you've been studying the recent OASIS changes, you may have experienced a little déjà vu as you reviewed the instructions at M0190 and M0210. But don't revert to old coding habits just yet.

Old way: Prior to October 2003, both M0190 (Inpatient diagnosis and ICD-9-CM code for conditions treated during an inpatient facility stay within the last 14 days) and M0210 (Medical diagnoses and ICD-9-CM codes at the level of highest specificity for those conditions requiring changed medical or treatment regimen) required only three digits, says Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX.

When the HIPAA code and transaction rule went into effect in October 2003, M0190 and M0210, in addition to M0230 and M0240 data elements, changed to require coders to code to the highest level of specificity, Selman-Holman says.

A twist: With the newest change to the OASIS manual, CMS changed the M0190 and M0210 data elements back to the original instructions -- three digits required, five digits optional. Because the purpose of M0190 and M0210 is risk adjustment, only three digits are required, so those two questions could require only three digits because the codes don't go on the claim (the claim is what has to be HIPAA-compliant), Selman-Holman says.

However, if CMS really intended to change any of the data elements, it would have to give notice. Since it didn't, both software (including HAVEN) and forms haven't been updated, Selman-Holman notes. But don't worry yourself with making changes in your forms, since CMS had no intention of revising any of the OASIS items, she says.