OASIS:
PPS REFINEMENTS INCLUDE THESE 5 OASIS CHANGES
Published on Mon May 28, 2007
Expert payment diagnoses to become much more complex.
Get ready for your OASIS instrument to look very different in some places.
The Centers for Medicare & Medicaid Services outlines plans to delete, modify and add items to the OASIS assessment in its May 4 request that the Office of Management and Budget approve extending use of the OASIS data set beyond the Aug. 31 expiration date.
Many parts of the OASIS assessment will stay the same under the prospective payment system refinements, including the time points for assessment, the absence of a requirement for locking data and the suspension of OASIS data collection for non-Medicare/non-Medicaid patients, CMS says.
Expect OASIS form overhaul: No matter what PPS changes CMS makes in response to industry comments, the OASIS assessment form will require changes for both initial and follow-up assessments.
Consider the following five major changes: 1. M0175 errors will no longer cost you money. Data show M0175 (From which of the following inpatient facilities was the patient discharged during the past 14 days) lacked predictive value for the case mix model, CMS explains. And the administrative headaches associated with M0175 affected agencies and intermediaries alike. So CMS proposes removing this M0 item from recertification and other follow-up assessments because it will no longer be part of the case mix calculation under the PPS update. CMS also plans to delete the reference to the follow-up assessment in the "NA" response in M0175.
"Although the pressure will be off case mix accuracy in answering M0175, this item will continue to be important for its impact on risk adjustment," notes consultant Judy Adams with Charlotte, NC-based LarsonAllen.
Prior location of the patient has little, if any, impact on care planning, Adams believes, and removing M0175 from OASIS would have been a good thing.
Waiting game: But CMS plans to make overall OASIS form changes in 2009, a CMS staffer said in the May 23 home health Open Door Forum. Agencies will just have to wait until then for the improvements. 2. M0110 will become part of the OASIS assessment. M0110 (Episode timing: Is the Medicare home health payment episode for which this assessment will define a case mix group an "early" episode or a "later" episode in the patient's current sequence of adjacent Medicare home health payment episodes) will be a new factor in the case mix calculation under the proposed PPS update.
The agency will choose from the options "early" for single episodes or the first two episodes in a sequence of adjacent episodes, or "later" for the third or later episodes, CMS explains.
Fine print: For these definitions, episodes don't have to directly follow one another but can be "adjacent"--spaced apart up to 60 days, CMS says. And the [...]
