Home Health Coding and OASIS Expert

Question: Our new patient is a hoarder. Can we report her hoarding as disruptive behavior in M1740 — Cognitive, behavioral, and psychiatric symptoms?

Virginia Subscriber

Answer: OASIS item M1740 asks you to identify whether your patient has any specific behaviors associated with significant neurological, developmental, behavioral, or psychiatric disorders that she demonstrates at least once a week.

Before you can report your patient’s hoarding in this item, you’ll need a physician-documented diagnosis, such as hoarding disorder. Although there is no specific code for this condition, it is generally considered to be an anxiety disorder and may be reported with 300.3 (Obsessive-compulsive disorder) or F42 (Obsessive-compulsive disorder) as it is considered a type of OCD — provided the physician documents this diagnosis.

If your patient has been diagnosed with hoarding disorder and the assessing clinician determines that the associated behaviors are a cause of concern for the patient and/or caregiver’s safety or wellbeing, then it would be appropriate to document this in M1740, the Centers for Medicare & Medicaid Services said in the January 2015 Quarterly OASIS Q&As.

It’s up to the assessing clinician to determine whether the patient’s hoarding behaviors meet the intent of Response 2 — Impaired decision-making: failure to perform usual ADLs or IADLs, inability to appropriately stop activities, jeopardizes safety through actions and/or Response 5 — Disruptive, infantile, or socially inappropriate behavior (excludes verbal actions).

Tip: If your patient has a hoarding disorder, consider this when selecting your responses to OASIS items M1720 — When Anxious and M1033 — Risk for Hospitalization if you feel the hoarding behavior is placing them at risk, especially for injury.

Note: Read the other January 2015 Quarterly OASIS Q&As here: https://www.qtso.com/download/hha/CMS_OAI_4th_Qtr_2014_QAs_01_21_15-Revised_1.pdf.