OASIS Alert

Errors and omissions no longer complicate the picture.

You might find it easier to think of the OASIS assessment as a work in progress -- constantly being refined, revised and reinterpreted. And your OASIS education must keep up with the changes, or your outcomes and finances will suffer.

More than two months after releasing a flawed OASIS revision, the Centers for Medicare & Medicaid Services posted a new copy Oct. 24.  "Chapter 8 has been corrected since the June 2006 release [actually posted in mid-August]. We apologize for any inconvenience," CMS says on its Web site. The information in the revised manual is effective immediately, CMS says.

Some of the more obvious errors were the severity ratings inserted in M0245 (Payment diagnoses) and the HIPAA compliant language about coding specificity removed from M0190 (Inpatient diagnoses and ICD-9-CM code categories). CMS corrected these in the new release.

Tip: If you have an incorrect and a corrected copy of the revisions, one way to be sure you are looking at the corrected copy is to go to M0245. If you see severity ratings, you are using an incorrect copy.

Another error: In M0450 (Current number of pressure ulcers at each stage), CMS removed language discussing healed Stage 2 pressure ulcers with and without scar formation. The statement "was just plain wrong," says OASIS expert Linda Krulish of Redmond, WA-based OASIS Answers. A healed Stage 2 pressure ulcer is no longer a pressure ulcer, whether or not it heals with scar tissue, she explains.

Better Explanations and Wordier Instructions

Other CMS corrections clarify confusing language or provide additional explanation. These include:

M0460 (Stage of most problematic [observable] pressure ulcer). Refers clinicians to the Wound Ostomy and Continence Nurses' Web site for access to specific guidance on staging pressure ulcers.

M0484 (Current number of [observable] surgical wounds). More clearly explains when a single surgical wound can become multiple surgical wounds.

M0670 (Bathing). Clarifies that this item does not assess the patient's ability to transfer into and out of the tub or shower.

M0830 (Emergent care). Elaborates on how to treat a "hold" after which the patient may or may not be admitted to the hospital at the end of the hold period.

Scenario 10 in Attachment C. Corrects the answer to M0488 (Status of most problematic [observable] surgical wound) to point out that the scenario doesn't provide enough information to answer that question.