OASIS Alert

Take a Closer Look at How OASIS Dressing Items Impact Reimbursement

When combined with a Neuro diagnosis, these items can fetch up to eight clinical severity points.

It's hard to isolate specific OASIS items and assign payment value, especially the two dressing items, M1810 and M1820, says M. Aaron Little, CPA, with BKD, in Springfield, Mo. This is because these items generate severity points that contribute to payment on several different levels, including:

1. One to four clinical severity points are generated IF primary or other diagnosis is scored with a Neuro 1 category diagnosis (brain disorders and paralysis) or Neuro 2 diagnosis (peripheral neurological disorders) AND M1810 or M1820 is scored with a 1, 2, or 3.

2. One to eight clinical severity points are generated IF primary or other diagnosis is scored with a Neuro 3 category diagnosis (stroke) AND M1810 or M1820 is scored with a 1, 2, or 3.

3. Two to four functional severity points are generated IF M1810 or M1820 is scored with a 1, 2, or 3.

Bottom line: Because these two items can generate both clinical and functional points, it is difficult to isolate the items and pinpoint payment impact, Little says. But, the following perspectives offer an idea of how these items may impact reimbursement, he says:

  • At least three clinical severity points are required to reach the moderate severity level and at least six points are required to reach the high severity level. When combined with the Neuro category diagnosis codes, these items provide anywhere from one to eight clinical severity points.
  • At least six functional severity points are required to reach the moderate severity level and at least seven points are required to reach the high severity level. These items provide anywhere from two to four functional severity points.

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