OASIS Alert

Published on Sat Feb 02, 2008 PDF

M0110 definition of 'adjacent' is a crucial concept for payment.

Question: When you are counting the days between episodes to see if they are adjacent for M0110, which is day 1?

Answer: An adjacent episode for M0110 is an episode that begins no more than 60 days after the previous episode ended -- and the crucial word here is "ended," says reimbursement consultant M. Aaron Little with BKD in Springfield, MO.

In its January 2008 OASIS question and answer 9, the Centers for Medicare & Medicaid Services explains how to count the days. If the patient was a Medicare fee-for-service patient for the whole 60-day episode, ending Jan. 6, count the first day after the end of the episode (Jan. 7 in this example) as Day 1. If the first day of the next episode is Day 60 or less, you have adjacent episodes, CMS says.

Watch for: If the patient was discharged before the episode ended and the episode will be paid as a partial episode payment, the episode would be considered to have ended on the date of the last billable visit and the day after that would be Day 1, CMS instructs in OASIS Q&A 10.