OASIS Alert

Hundreds of dollars hang in the balance.

Question: We have a number of patients who have IVs that we keep open by administering intermittent flushes with heparin or a saline. How do we answer M0250 for these patients?

Answer: If the patient receives intermittent medications or fluids via the IV line - including heparin or saline flushes - mark response "1" (Intravenous or infusion therapy, excludes TPN), according to the Center for Medicare & Medicaid Services' response-specific instruction for M0250. This response adds 14 points to the clinical severity domain for that patient's Home Health Resource Group score and adds hundreds of dollars to an episode payment.

Watch for: This approach differs from how M0250 treats feeding tubes. CMS instructs that a flush of a feeding tube does not trigger a check in response "3" (enteral nutrition), because a feeding tube flush doesn't provide nutrition.