OASIS Alert

Start preparing your staff and clinicians now for the M0 item changes.

With agencies counting down the weeks until they must use the new prospective payment system, CMS finally released the updated OASIS data set.

The Centers for Medicare & Medicaid Services has issued the finalized OASIS dataset, OASIS B-1 (1/2008), that takes into account the prospective payment system refinements that will hit Jan. 1. The new OASIS tool will add M0110 on early/late episodes to all assessments. And the new therapy item, M0826, will replace the current M0825.

Downside: Both these items will require process and systems changes as well as clinician training to get them right.

Upside: Your intermediary will correct these items when they are wrong, both in favor of the intermediary and the agency.

Other changes in the OASIS items include adding M0470, M0474, M0520 and M0800 to recertification and follow-up assessments and dropping M0175 and M0610, CMS notes on its Web site. And the new diagnosis coding item, M0246, will replace the current M0245.

Create An Agency-Wide Effort To Tackle M0110

OASIS data set issues will be primarily systems or process issues, says senior clinical consultant Judy Adams with Charlotte, NC-based LarsonAllen. The clinician needs accurate information to answer M0110 and this will require cooperation, she adds. Agencies will need systems in place to capture that information.

Example: Intake or billing will need to query DDE and the Common Working File when the agency receives the referral, to see if another agency is currently seeing the patient and when the last two home health episodes occurred. Then the agency will need a system to recheck this information when it's time to submit the bill. This will allow the agency to adjust revenue expectations based on the most recent information, Adams explained.

Although intermediaries will adjust the answers to M0110, being aware of the correct information will help agencies track their revenue and correct their receivables in light of any changes, she adds.

Deciding how many therapy visits a patient needs is also a process issue, Adams says. Nursing and therapy will need to coordinate evaluations so they can collaborate on answering M0826 within the agency's time limit for completing the OASIS assessment.

Agencies must use the new version of OASIS (1/2008) effective Dec. 27 for all recertification assessments completed during the five-day window for episodes that begin on or after Jan. 1, the National Association for Home Care & Hospice explains to its members. "However, during this same time period, the current version of OASIS (12/2002) must continue to be used for all Start of Care, Recertification, and Significant Change in Condition assessments if the episode start date is in 2007," NAHC cautions.

Hidden trap: Don't jump the gun. Although agencies are to begin using RFA 4 and 5s Dec. 27, wait to use the other assessments until Jan. 1.

Note: The new OASIS dataset is at www.cms.bhhs.gov/HomeHealthQualityInits/12_HHQIOASISDataSet.asp under the "Down-loads" section, dated 2008/01.