OASIS Alert

Reader Question:

YOU MAY HAVE ALWAYS USED '0' -- BUT IS IT RIGHT?

Agencies have stuck with old CMS system.

Question: Are we allowed to use "0" as a frequency in writing orders? For example, if the orders are to see a patient every other week for twelve weeks, can we write "1 wk 1, 0 wk 2, 1 wk 3" etc.

Answer: No, the Centers for Medicare & Medicaid Services says, because  "0" is not a recognized visit frequency.

In response to a National Association for Home Care & Hospice question, CMS explained that the shorthand notation such as "1 wk 1" is a holdover from a 1980s HCFA 486 automation project CMS never completed, and the feds no longer require it. CMS does not demand a notation system; agencies must write orders that are "clear to anyone reading the plan of care as to who is visiting, and how often," NAHC reports.

Even if you're writing an order for a discipline that won't start until later in the episode, it is incorrect to use "0" as a frequency, says consultant Susan Justice-Moran with Ft. Lauderdale, FL-based Justice-Moran & Associates. Instead, write the date the discipline will begin, such as "PT 3 x wk x 2, beginning June 5," she explains.

The bottom line: If a clinician will visit every other week, an order might say something like: "SN every other week for 12 weeks, until the week of June 5," CMS confirms.

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