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OASIS Alert

Assessment :

M0250 Can Dramatically Raise Clinical Severity Reimbursement

Published on Tue Jul 01, 2003

Make sure clinicians understand M0250, since their answers to this item can increase either your patient's prospective payment system reimbursement - or your intermediary's scrutiny.

M0250 asks whether a patient receives intravenous or infusion therapy, including parenteral or enteral nutrition at home. Answers one through three add points to the clinical severity dimension, explained Linda Krulish, OASIS expert and president of Home Therapy Services in Redmond, WA, speaking at a recent teleconference sponsored by the Associated Home Health Industries of Florida.

Answer "1" (Intravenous or infusion therapy, excludes TPN) adds 14 points to the patient's score. Answer "2" (Parenteral nutrition, TPN or lipids) adds 20 points. And answer "3" (Enteral nutrition, nasogastric, gastrostomy, jejunostomy or any other artificial entry into the alimentary canal) adds 24 points.

Adding 24 points "would already put this patient into the second-highest clinical severity reimbursement level," Krulish said.

As in many OASIS assessment items, the question itself doesn't provide enough information for consistent, accurate and standardized scoring, Krulish reminded listeners. You need to refer to the response-specific instructions in Chapter 8 of the OASIS manual for additional help.

Keep In Mind:

  • Just flushing the feeding tube that is being kept in place but not used would not merit answer "3", since it doesn't count as receiving nutrition.

  • If the patient receives more than one therapy, apply only the highest point value.

  • If the assessment you are doing will lead to the patient receiving one of the intravenous or infusion therapies - perhaps you will get doctor's orders for one of them as a result of the assessment - mark that therapy in your answer.

  • Even if your agency doesn't provide the infusion or parenteral/enteral therapy, you should answer M0250 indicating what therapy the patient receives at home. You still get points for clinical severity, even if an infusion company provides the therapy, says consultant Terri Ayer, with Tucson-based Ayer Associates.

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