OASIS Alert

Make sure your clinician understands the majority rule.

Question: When we are answering M0660 (Ability to dress lower body) for a patient who wears TED anti-embolism stockings, are those stockings considered lower body clothing?

Answer: Yes. Even though the M0 item refers to "lower body clothing," the clinician should consider a prescribed lower extremity supportive or protective device -- such as elastic compression stockings -- when answering M0660, the Centers for Medicare & Medicaid Ser-vices says in answering question 132.3 of the OASIS Q&As.

Hidden trap: M0660 evaluates the patient's ability to obtain, put on and remove lower body dressing items. This may seem clear, but your clinicians need specific OASIS training to know that this doesn't mean the patient can put on and take off all the appropriate items. Instead, the standard for this question is the "majority" of items, CMS confirms in Q&A 132.2. And the clinician must not decide some items are more important than others. OASIS is a data set, so objective rules must apply, CMS says.

Example: A clinician may believe it is more important for a post-stroke patient to be able to put on compression stockings than to put on her shoes, but when deciding whether she meets the majority standard, both items must be treated equally. The clinician should document her concern about the patient's problem with the compression stockings elsewhere in the comprehensive assessment, CMS says.

Note: OASIS Q&As are found at www.qtso.org, near the bottom of the page.