OASIS Alert

Published on Fri Jan 28, 2011 PDF

It's a good time to make certain your OASIS submission procedures are top-notch, since intermediaries will be checking that you have OASIS data submitted for claims you file.

When OASIS C started in January 2010, "submission of the OASIS became a condition of payment," home health MAC NHIC explains on its website. "CMS requires medical reviewers to ensure the OASIS has been submitted and accepted to the state repository." Missing OASIS data will result in denied claims.

"Upon review, NHIC Corp is finding claims where the OASIS is not present in the state repository," the MAC cautions. "Providers must ensure they are meeting this requirement."

And it won't be good enough to submit OASIS data after the fact. "If a provider receives a denial because the OASIS was not found, they must submit evidence of submission and acceptance of the OASIS prior to submission of the claim with their appeal," NHIC says.

Good news: The Joint Commission heard your concerns about the National Patient Safety Goal on medication reconciliation and has made revisions. The Oakbrook Terrace, Ill.-based accrediting body's Board of Commissioners approved changes to the goal, effective in July 2011, the Joint Commission reports. "The NPSG was revised based on input from the field about difficulties with implementation of the 2009 version of the NPSG because it was too prescriptive and detailed."

The new goal reads, "Maintain and communicate accurate patient medication information" and includes five elements of performance. More information is online at www.jointcommission.org/npsg_reconciling_medication.

New tools may help you to improve outcomes in your patients with better recognition of anxiety disorders. Thanks to a helping hand from the National Institutes of Health.

Anxiety disorders affect up to 14 percent of older adults, the NIH estimates. "Anxiety disorders can severely affect a person's life, and they are often overlooked in older adults," the NIH says in a release.

"Conditions that commonly occur with age, such as depression, heart disease and diabetes, may have symptoms that mimic or mask anxiety symptoms, making diagnosis in older adults difficult," says physician Thomas R. Insel, director of the National Institute of Mental Health.

Patient-friendly information about anxiety disorders in the elderly is online at www.nihseniorhealth.gov.

Claims system changes have given rise to payment problems in the new year. "Home health Requests for Anticipated Payments (RAPs), claims, and adjustments with 2010 dates of service that completed processing after January 1, 2011, have incorrect payment amounts," regional home health intermediary Cahaba GBA tells providers in a message. "Cahaba has notified the Fiscal Inter-mediary Standard System (FISS) maintainer."

And home health and hospice claims are among those being incorrectly suspended with reason code 39011 due to a "timeliness editing issue," reports Medicare contractor National Government Services. The issue is being researched and providers shouldn't take any action on such claims, NGS says.