Home Health Coding and OASIS Expert

Question: When we make the switch to OASIS-C1/ICD-9 effective January 1, 2015 I understand that the responses for depression intervention OASIS item M2250 — Plan of Care Synopsis, Row d will change.

When will it be appropriate to select “Yes” to indicate that the physician was notified of a positive depression screening in M2250, Row d? If I leave a voice mail for the physician indicating that the patient had a positive depression screening, can I select “Yes?” What about for M2400 — Intervention Synopsis, Row c?

Answer: The wording for OASIS item M2250, Row d will change slightly in OASIS-C1/ICD-9. The new item will read “Depression intervention(s) such as medication, referral for other treatment, or a monitoring plan for current treatment and/or physician notified that patient screened positive for depression” (changed wording in italics).

When completing M2250d, you may answer “Yes” in cases where “the physician was notified of the positive depression screening by the end of the allowed assessment time period,” the Centers for Medicare & Medicaid Services said in July 2014 Quarterly OASIS Q&As. You can communicate the patient’s status to the physician by telephone, voicemail, electronic means, fax, or any other appropriate method, CMS said. And you don’t need to receive an acknowledgement of your message in order to select “Yes” for this item.

Caution: While you can answer “Yes” to M2250d in OASIS-C1/ICD-9 after simply notifying a physician of a patient’s positive depression screening, answering “Yes” in other situations isn’t quite as easy. “Other than for situations of physician notification regarding a positive depression screen, a physician’s order for the depression intervention is required” to answer “Yes,” CMS said in the Q&As.

M2400c, on the other hand, does not offer the option of notifying the physician of a positive depression screening, CMS pointed out. So, when selecting your M2400c response for a patient with no orders for depression or no referral for other treatment, your response should be “No,” unless the patient meets the criteria listed to mark “NA.”

Different: In OASIS-C1/ICD-9, item M2400c does have new criteria for selecting “NA.” Currently, you’re instructed to select “NA” when “Formal assessment indicates patient did not meet criteria for depression AND patient did not have diagnosis of depression since the last OASIS assessment.” Under OASIS-C1/ICD-9, the “NA criteria change to “Patient has no diagnosis of depression AND every standardized, validated depression screening conducted at or since the last OASIS assessment indicates the patient has: 1) no symptoms of depression; or 2) has some symptoms of depression but does not meet criteria for further evaluation of depression based on screening tool used.”

Note: Read all of the July 2014 Quarterly OASIS Q&As here: www.oasisanswers.com/aboutoas_links.htm. Scroll down to the OASIS Questions & Answers section and click on the July 2014 link.