OASIS Alert

You don't need to be an optician for this M0 item.

Question: When evaluating a patient's vision for M0390, you can mark him "2" (Partially impaired) or "3" (Severely impaired) in which of the following situations:

(A) A car accident has left his eyes temporarily swollen shut.

(B) The patient is blind in his left eye with normal vision in his right.

(C) The patient wears a neck brace that keeps him from lowering his chin.

1. A and B only;

2. A and C only;

3. All of the above.

Answer: 2. A and C only. A patient could be blind in one eye and appropriately be scored a "0" for M0390 (Normal vision), the Centers for Medicare & Medicaid Services says in OASIS question and answer 6 of the July 2007 OASIS Q&As.

This would be true if with his existing vision he can see adequately in most situations and can see medication labels or news-print, CMS explains.

On the other hand, in answering M0390, you would consider "physical defi-cits or impairments that limit the patient's ability to use [his] existing vision in a functional way," CMS says. So with limited neck movement, the patient might not be able to see obstacles in his path. Or swollen eyes might mean he couldn't see medication labels, at least temporarily, CMS illustrates.

Bottom line: M0390 considers the patient's functional vision, not whether the patient has 20/20 vision. v

Note: The July Q&As are available at http://www.oasiscertificate.org, under "resources."