OASIS Alert

Question: Our agency is trying to improve accuracy in answering M0420 and M0430. We had planned to follow the instructions in the 3M National OASIS Integrity Project that tell you to answer "yes" to M0430 (intractable pain) if you've answered "2" or "3" to M0420 (frequency of pain interfering with activity). Many of our clinicians, especially therapists, disagree with this approach. They argue that a patient can have daily pain interfering with activities without having intractable pain. How do we answer in these situations?

Answer: You can correctly answer "2" on M0420 and "no" on M0430, advises OASIS expert Linda Krulish with Redmond, WA-based Home Therapy Services. Rather than making a "black and white" scoring decision, focus first on the definitions in the questions, she suggests.

M0430 contains this definition of intractable pain: "pain that is not easily relieved, occurs at least daily, and affects the patient's sleep, appetite, physical or emotional energy, concentration, personal relationships, emotions, or ability or desire to perform physical activity." The issue of whether the pain is "not easily relieved" is not addressed in M0420, Krulish explains.

M0420 asks about the frequency with which pain interferes with activity. A patient can have pain that interferes with activity at least daily - resulting in a score of "2" on M0420 - and still have a " pharmacological or non-pharmacological approach that, once implemented, could easily relieve the pain, thus not making it meet the M0430 definition of intractable," Krulish tells Eli.