OASIS Alert

Published on Sat Jan 21, 2006 PDF

If you're following the original version of regional home health intermediary Associated Hospital Service's recently revised M0250 question and answer, you could be leaking cash with every infusion.

OASIS item M0250 (Therapies the patient receives at home) can add from 14 to 24 points to the clinical severity domain of the home health resource group, depending on what infusion therapy the patient receives. These points move the clinical score to low or moderate, adding up to $600 to the episode reimburse-ment (see OASIS Alert, Vol. 6, No. 12).

Mistake: Before Jan. 11, AHS' Q&A instructed home health agencies that if a patient was receiving intravenous, parenteral nutrition or enteral nutrition therapy, but these were administered by a durable medical equipment provider, the correct response to M0250 was "4" (none of the above). 

When questioned, a Centers for Medicare & Medicaid Services spokesperson agreed that this instruction was misleading. "M0250 does not ask who is providing the service or paying for the service, only if the service is provided in the home," the spokesperson stresses.

Action step: Follow the revised Q&A AHS posted Jan. 11, "If a DME company is providing the services in the home, then the answer would be 1, 2, or 3 because the services are being provided in the home."

Don't overlook: Even if the DME company is providing the service, the HHA should evaluate and document other related information, such as the patient's nutritional or hydration status and signs of infection, the spokesperson cautions.