OASIS Alert
New Coding Examples Are Online
PDF
Thanks to October's introduction of V and E codes into the diagnosis coding mix, agencies need all the coding help they can get. The Centers for Medicare & Medicaid Services posted Sept. 30 an overview of how clinicians should approach M0230, M0240 and M0245 under the new rules. The document "OASIS Diagnosis Reporting Case Examples" contains detailed discussions of case examples to illustrate the changes. The examples include some of the more troublesome issues frequently encountered in home care, including a case in which the patient's diabetes is not primary; a diabetic patient with a stasis ulcer; a patient post-mastectomy; a diabetic receiving postoperative care; and a patient with a hip fracture. One problem with the examples is CMS didn't really spell out that when you have a diagnosis in M0240, you don't always have to have one in M0245, says National Association for Home Care & Hospice VP of Regulatory Affairs Mary St. Pierre. But the new examples probably won't shed much light on the topic. They are pretty much the same as the ones CMS already had put out, they just "wiggled the old ones around," she says. The case examples are at www.cms.hhs.gov/providers/hhapps/diagnosis.pdf.
The new software, which reflects the payment rate update that took effect Oct. 1, is available at http://cms.hhs.gov/providers/pricer. Focusing on a July General Accounting Office report (www.gao.gov/new.items/d03561.pdf) Grassley said he would demand a "timeline" from CMS for taking GAO-recommended steps to strengthen oversight of the state survey process. But CMS Administrator Tom Scully noted a potential impediment to long-term improvements: CMS' funding for overseeing the survey process has been held flat for several years. Grassley said he would ask the GAO "to look into the adequacy of federal funding for state survey and certification activities - not just for nursing homes but for other providers, such as home health care."
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New Coding Examples Are Online
Thanks to October's introduction of V and E codes into the diagnosis coding mix, agencies [...]