OASIS Alert

Here's one more reason you should keep up with the latest Q&As.

If you are supposed to mark "0" for a urostomy, what do you mark for a nephrostomy?

Question: Look at M0520 (Urinary incontinence or urinary catheter presence), including the response-specific instructions. Decide whether you would answer "0 - No incontinence or catheter" or "2 - patient requires a urinary catheter" in the following situations:

1. When the patient has a urinary di-version, with or without a stoma, which is pouched for drainage?

2. When the patient has a nephrostomy tube?

3. When a patient has a continent urinary diversion (the patient has a stoma but accesses it with intermittent catheterizations)?

Answer: 1. When a patient has urinary diversion, with or without a stoma, which is pouched for drainage, the appropriate M0520 response would be "0 - No incontinence or catheter," the Centers for Medi-care & Medicaid Services says in response to the question from the National Associa-tion for Home Care & Hospice.

2. For a patient with urinary diversion, with or without a stoma, that has a catheter or "tube" for urinary drainage, the appropriate M0520 response would be "2 - Patient requires a urinary catheter (i.e., external, indwelling, intermittent, suprapubic)," CMS clarifies.

3. Response 2 also is appropriate for a patient who requires intermittent catheterization, even if the patient has a continent urinary diversion, CMS adds.

Note: For other OASIS M0 clarification from April, go to http://www.oasiscertificate.org and click on "Resources" and then on "CMS Q&As April 2008."