OASIS:
TAKE STOCK OF THESE PPS OASIS CHANGES NOW
Published on Mon Aug 27, 2007
Case mix overhaul demands fast action.
Come January, your staff's OASIS assessment skills will be even more vital to securing the payments your agency deserves.
The final rule on the home health prospective payment system, released Aug. 22 by the Centers for Medicare & Medicaid Services, makes significant changes in how the OASIS will be used to calculate case mix payment groups, notes Mark Sharp of BKD in Springfield, MO.
Time it right: The new PPS and the related changes to OASIS will go into effect Jan. 1. Because of the five-day window on OASIS assessments, Dec. 27 is the first date agencies can collect OASIS data that must be used for the new PPS, confirms Judy Adams with Charlotte, NC-based LarsonAllen.
CMS is working to make sure OASIS and HAVEN will be ready in time for Dec. 27, when home health agencies will have to start collecting the new PPS data, CMS' Pat Sevast assured stakeholders listening to a forum on proposed changes earlier this summer (see Eli's HCW, Vol. XVI, No. 20).
That means it's not a minute too soon to start training staff about the revisions--including a refresher on the need for OASIS accuracy in general.
Reality: Most agencies already spend plenty in labor costs related to catching and correcting OASIS errors, says Melanie Duerr of VNA of Hudson Valley in Tarrytown, NY. Training can help stop that drain on the bottom line--and will prove especially valuable now given the OASIS changes.
In revamping OASIS, CMS stuck closely to the plan laid out in its proposed rule. Here are the key ways the final rule affects OASIS coding:
• The final rule shakes up the items in case-mix calculations. As proposed, CMS will eliminate M0175 (From which of the following inpatient facilities was the patient discharged during the past 14 days?) from payment rate determinations starting next year.
Out with the old: In addition to dropping M0175 from the case mix, the final rule drops these items from the payment equation: M0530 (incontinence), M0440 (skin lesions) and M0610 (behaviors observed).
In with the new: Starting next year, M0800 (injectable meds) will be added to the list of OASIS items used to determine case mix.
• Like it or not, you'll have to determine if an episode is "early" or "late." The final rule creates the OASIS item M0110 (episode timing), designed to capture whether a given assessment is for an "early" or "later" episode in the patient's current sequence of adjacent Medicare home health payment episodes (see Eli's HCW, Vol. XVI, No. 26).
Coding basics: For M0110, you can choose from these options: "early" for sole, first or second episode in a sequence of adjacent episodes; "later" for third or later episodes; "UK" for unknown if [...]
