Home Health ICD-9/ICD-10 Alert

Are you missing out on Neuro 1 case mix points?

Answering the OASIS items associated with earning Neuro 1 case mix points isn’t always straightforward and there are plenty of stumbling blocks that could result in the loss of case mix points. Keep these tips in mind to help make sure they are being scored accurately.

OASIS items M1810 -- Current ability to dress upper body safely and M1820 -- Current ability to dress lower body safely assess the patient’s ability to safely get dressed and undressed with or without dressing aids, says Pat Jump, MA, BSN, RN, COS-C, with Rice Lake, Wis.-based Acorn’s End Training & Consulting.

When the clinician selects responses for these items, she should consider the clothing the patient routinely wears and the patient’s ability to manage the zippers, buttons, snaps, hooks, etc., associated with his usual clothing style, Jump says. If a client modifies the clothing he wears due to a physical impairment, the modified clothing selection will be considered routine if there is no reasonable expectation that the client could return to the previous style of dressing.

Remember: Devices are part of body apparel so you should include splints, corsets, braces, and knee immobilizers when assessing for these items, Jump says.

Don’t miss: The patient’s ability to get dressed includes his ability to get to where his clothes are usually stored.

For item M1840 -- Toilet Transferring, toilet transfer means that the patient is getting from a seated position to standing, ambulating to the room where the toilet is, getting on the toilet, getting back up, and then returning to the room, says Lista L. Clark, RN, BSN with Healthcare Provider Solutions in Nashville, TN.

So M1840 can’t be "0 -- Able to get to and from the toilet and transfer independently with or without a device" if the patient needs help with transfers. This is a common misconception, Clark says. Clinicians often think "toilet transfer" means just getting on and off the toilet, she says.