Blog

Please enjoy The Home Health Navigator Blog intended to provide an outlet for FORCE Billing and Coding to share valuable, timely information about Home Health Agency Billing, Coding, and Compliance. Experienced members of our staff will be providing insight on the issues they face every day. Please feel free to join in the discussion by asking questions, leaving comments, or sharing our blog posts with your colleagues.

The New OASIS C2 Will Take Effect January 1 2017

< Back to Blogs

Posted: 14th Jan 2016

The New OASIS C2 Will Take Effect January 1 2017 The CMS has changed some items on the OASIS once again, and this will take effect on January 1st, 2017. The new items are: M1028- Active Diagnoses- Comorbidities and Co-existing Conditions: This item was added after M1025. Here is what it will look like: Active Diagnoses- Comorbidities and Co-existing Conditions See OASIS Guidance Manual for a complete list of relevant ICD-10 codes.

⃞   1 - Peripheral Vascular Disease (PVD) or Peripheral Arterial Disease (PAD)
⃞   2 - Diabetes Mellitus (DM)

M1060-Height and Weight: This item was added after item M1056 to document the patient’s height and weight.

GG017c- Mobility: This item has been added after M1850. This is what it looks like:

Section GG: FUNCTIONAL ABILITIES and GOALS – SOC/ROC (GG0170C) Mobility Code the patient’s usual performance at the SOC/ROC using the 6-point scale. If activity was not attempted at SOC/ROC, code the reason. Code the patient’s discharge goal using the 6-point scale. Do not use codes 07, 09, or 88 to code discharge goal. Coding: Safety and Quality of Performance – If helper assistance is required because patient’s performance is unsafe or of poor quality, score according to amount of assistance provided. Activity may be completed with or without assistive devices. 06 Independent – Patient completes the activity by him/herself with no assistance from a helper. 05 Setup or clean-up assistance – Helper SETS UP or CLEANS UP; patient completes activity. Helper assists only prior to or following the activity. 04 Supervision or touching assistance – Helper provides VERBAL CUES or TOUCHING/STEADYING assistance as patient completes activity. Assistance may be provided throughout the activity or intermittently. 03 Partial/moderate assistance – Helper does LESS THAN HALF the effort. Helper lifts, holds or supports trunk or limbs, but provides less than half the effort. 02 Substantial/maximal assistance – Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 01 Dependent – Helper does ALL of the effort. Patient does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the patient to complete the activity. If activity was not attempted, code reason: 07 Patient refused 09 Not applicable 88 Not attempted due to medical condition or safety concerns 1. SOC/ROC Performance 2. Discharge Goal  Lying to Sitting on Side of Bed: The ability to safely move from lying on the back to sitting on the side of the bed with feet flat on the floor, and with no back support M1311-Current number of unhealed pressure ulcers at each stage: This item was changed from M1308 to M1311. Here is what it will look like:

(M1311) Current Number of Unhealed Pressure Ulcers at Each Stage Enter Number A1. Stage 2: Partial thickness loss of dermis presenting as a shallow open ulcer with red pink wound bed, without slough. May also present as an intact or open/ruptured blister. Number of Stage 2 pressure ulcers [If 0 at FU/DC Go to M1311B1] A2. Number of these Stage 2 pressure ulcers that were present at most recent SOC/ROC – enter how many were noted at the time of most recent SOC/ROC B1. Stage 3: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. Number of Stage 3 pressure ulcers [If 0 at FU/DC Go to M1311C1] B2. Number of these Stage 3 pressure ulcers that were present at most recent SOC/ROC – enter how many were noted at the time of most recent SOC/ROC C1. Stage 4: Full thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often includes undermining and tunneling. Number of Stage 4 pressure ulcers [If 0 at FU/DC Go to M1311D1] C2. Number of these Stage 4 pressure ulcers that were present at most recent SOC/ROC – enter how many were noted at the time of most recent SOC/ROC D1. Unstageable: Non-removable dressing: Known but not stageable due to non-removable dressing/device Number of unstageable pressure ulcers due to non-removable dressing/device [If 0 at FU/DC Go to M1311E1 D2. Number of these unstageable pressure ulcers that were present at most recent SOC/ROC – enter how many were noted at the time of most recent SOC/ROC E1. Unstageable: Slough and/or eschar: Known but not stageable due to coverage of wound bed by slough and/or eschar Number of unstageable pressure ulcers due to coverage of wound bed by slough and/or eschar [If 0 at FU/DC Go to M1311F1] E2. Number of these unstageable pressure ulcers that were present at most recent SOC/ROC – enter how many were noted at the time of most recent SOC/ROC F1. Unstageable: Deep tissue injury: Suspected deep tissue injury in evolution Number of unstageable pressure ulcers with suspected deep tissue injury in evolution [ If 0 - Go to M1322 (at Follow up), Go to M1313 (at Discharge)] F2. Number of these unstageable pressure ulcers that were present at most recent SOC/ROC – enter how many were noted at the time of most recent SOC/ROC

M1313-Worsening in pressure ulcer status since SOC/ROC: This item was changed from M1309 to M1313. The difference is the Roman numerals changed to Arabic numbers. Here is what it will look like:

(M1313) Worsening in Pressure Ulcer Status since SOC/ROC: Instructions for a-c: Indicate the number of current pressure ulcers that were not present or were at a lesser stage at the most recent SOC/ROC. If no current pressure ulcer at a given stage, enter 0. Enter Number a. Stage 2 b. Stage 3 c. Stage 4 Instructions for e: For pressure ulcers that are Unstageable due to slough/eschar, report the number that are new or were at a Stage 1 or 2 at the most recent SOC/ROC. d. Unstageable – Known or likely but Unstageable due to non-removable dressing. e. Unstageable – Known or likely but Unstageable due to coverage of wound bed by slough and/or eschar. f. Unstageable – Suspected deep tissue injury in evolution.

M1501- Symptoms in Heart Failure Patients: This item has been changed from M1500 to M1501. Here is what it will look like: (M1501) Symptoms in Heart Failure Patients: If patient has been diagnosed with heart failure, did the patient exhibit symptoms indicated by clinical heart failure guidelines (including dyspnea, orthopnea, edema, or weight gain) at the time of or at any time since the most recent SOC/ROC assessment? Enter Code No [Go to M2005 at TRN; Go to M1600 at DC ] Yes Not assessed [Go to M2005 at TRN; Go to M1600 at DC ] Patient does not have diagnosis of heart failure [Go to M2005 at TRN; Go to M1600 at DC ]

M1511-Heart Failure Follow-up: This item has been changed from M1510 to M1511. (M1511) Heart Failure Follow-up: If patient has been diagnosed with heart failure and has exhibited symptoms indicative of heart failure at the time of or at any time since the most recent SOC/ROC assessment, what action(s) has (have) been taken to respond? (Mark all that apply.) 0 - No action taken 1 - Patient’s physician (or other primary care practitioner) contacted the same day 2 - Patient advised to get emergency treatment (for example, call 911 or go to emergency room) 3 - Implemented physician-ordered patient-specific established parameters for treatment 4 - Patient education or other clinical interventions 5 - Obtained change in care plan orders (for example, increased monitoring by agency, change in visit frequency, telehealth)

M2001- Drug Regimen Review: This item has been changed from M2000 to M2001. Here is what it looks like: (M2001) Drug Regimen Review: Did a complete drug regimen review identify potential clinically significant medication issues? Enter Code 0 No - No issues found during review [Go to M2010] 1 Yes - Issues found during review 9 NA - Patient is not taking any medications [Go to M2040]

M2003- Medication follow-up: This item has been changed from M2002 to M2003. Here is what it looks like: (M2003) Medication Follow-up: Did the agency contact a physician (or physician-designee) by midnight of the next calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues? Enter Code 0 No 1 Yes M2005- Medication Intervention: This item has been changed from M2004 to M2005. Here is what it looks like: (M2005) Medication Intervention: Did the agency contact and complete physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the SOC/ROC? Enter Code 0 No 1 Yes 9 NA – There were no potential clinically significant medication issues identified since SOC/ROC or patient is not taking any medications M2016- Patient/Caregiver Drug Education Intervention: This item has been changed from M2015 to M2016. Here is what it looks like: (M2016) Patient/Caregiver Drug Education Intervention: At the time of, or at any time since the most recent SOC/ROC assessment, was the patient/caregiver instructed by agency staff or other health care provider to monitor the effectiveness of drug therapy, adverse drug reactions, and significant side effects, and how and when to report problems that may occur? Enter Code 0 No 1 Yes NA Patient not taking any drugs M2301- Emergent Care: This item has been changed from M2300 to M2301. Here is what it looks like: (M2301) Emergent Care: At the time of or at any time since the most recent SOC/ROC assessment has the patient utilized a hospital emergency department (includes holding/observation status)? Enter Code 0 No [Go to M2401] 1 Yes, used hospital emergency department WITHOUT hospital admission 2 Yes, used hospital emergency department WITH hospital admission UK Unknown [Go to M2401] M2401- Intervention Synopsis: This item has been changed from M2400 to M2401. The difference is that instead of saying: Intervention Synopsis: (Check only one box in each row.) At the time of or at any time since the most recent OASIS assessment, were the following interventions BOTH included in the physician-ordered plan of care AND implemented? It says: Intervention Synopsis: (Check only one box in each row.) At the time of or at any time since the most recent SOC/ROC assessment, were the following interventions BOTH included in the physician-ordered plan of care AND implemented?