Home Health Coding and OASIS Expert

Item Focus:

Don't Miss this M2250 Update

You need physician authorization for all but these two interventions.

OASIS item M2250 — Plan of Care Synopsis gives you an opportunity to take credit for interventions in the physician-ordered plan of care. Know the requirements for each type of intervention to give your process measures a boost.
 
Get Your Orders
Many of the interventions covered in M2250 require you to communicate a need with the physician and receive verbal orders within the allowed time frame. For Start of Care assessments, you have five days to collect the orders, for Resumption of Care assessments, you have two days.
 
Two of the areas for interventions — Row d: Depression and Row g: Pressure ulcer treatment — allow you to answer “1 — Yes” for simply requesting interventions from the physician.
 
 
New in OASIS-C1: The new OASIS changes the criteria for selecting an “NA” response in every row except Row a., said Sharon Litwin, RN, BS, MHA, with 5 Star Consultants in Camdenton, Mo.
 
Also new in OASIS-C1 is the option to answer Row d. “1 — Yes” if you have notified the physician about a positive depression screening result, Litwin said during the Eli-sponsored audioconference OASIS-C1/ICD-9: Are You Ready? You don’t need to hear back from the physician to submit a “Yes” response for this row or for Row g, if appropriate.
 
Follow the tips in the chart on page 39 for answering each row of M2250 correctly. If neither “Yes” nor “NA” applies, select “No.”
 
Scenario: After completing a Start of Care comprehensive assessment for your new patient, you called the physician’s office and left a message regarding your assessment findings, including a positive PHQ-2 score of “4.” The physician’s nurse calls back the next day with no further instructions or interventions regarding the positive depression screening. How would you complete M2250, Row d?

Answer: The correct response is “1 — Yes,” said Linda Krulish, PT, MHS, COS-C, president of Redmond, WA-based OASIS Answers during the Centers for Medicare & Medicaid Services OASIS-C1 implementation webinar.
 
The Chapter 3, response-specific instructions for M2250, Row d advise “If the physician-ordered Plan of Care contains orders for further evaluation or treatment of depression, AND/OR if the physician has been notified about a positive depression screen, select ‘Yes.’”
 
Note: To listen to the CMS OASIS-C1 implementation webinar, visit www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/OASIS/Training.html and scroll down to the downloads section to find the recording.