OASIS Alert

Published on Wed May 05, 2004 PDF

Q: When a case-mix diagnosis is displaced from M0230 because of a V code and is put in M0245 instead, do you still need to put the diagnosis in M0245 on the plan of care?

A: Yes, even though there is no specific locator on the plan of care for the M0245 diagnosis. In its frequently asked questions for February, regional home health intermediary Cahaba GBA explains that the plan of care must contain all pertinent diagnoses and be signed by the physician. "If the case-mix diagnosis is not present on the plan of care or other verbal order at the time of the initial certification or recertification, the claim may be downcoded," Cahaba warns.