Healthcare Provider Solutions

Hopefully your preparation for OASIS-C2 implementation has begun and due to that your Thanksgiving, Christmas and New Year’s Celebration will NOT be stressful. January 1, 2017 will bring with it multiple changes in the OASIS-C2 Data Set. The final version of the OASIS-C2 Guidance Manual has been released and contains all the updates for implementation. The primary format change that was made is to provide a single box, on most of the items, to fill in the response, versus marking a response.  This will help with some of the confusion in which box was actually marked or the accidental marking of more than one when only one applies.

Example:

OASIS-C2 2017

OASIS-C1 2016

Another change that doesn’t seem to be such a big deal is the change from Roman Numerals to Arabic.
So we will now see Stage 4 instead of Stage IV.

In order to help comply with the Impact Act Requirements there have been three brand new items
added to the data set that could prove to be, at least in part, problematic.  These items are:

  • M1028:   Active Diagnoses-Comorbidities and Co-existing Conditions – Check All that Apply – PVD/PAD/DM
  • M1060:  Height & Weight
  • GG0170C:  Mobility

To elaborate on each:  M1028 – this is a very scary item and several questions have been posed to CMS regarding this, in hopes that clarification will be issued prior to January 1, 2017.  The issue is that the question guidance states that the code can only be marked if it has been documented as “active” by the physician or it can be inferred as active by statements of med management, treatment changes, etc. It does not specifically state that there is a requirement that these codes be reflected on the OASIS, where only 6 diagnoses can be entered at M1020 & M1022.  This is confusing and hopefully further clarification will be issued prior to January 1.

M1060 – Height & Weight – Record most recent height measurement and most recent weight measurement in last 30 days.  Agencies are encouraged to request this information as part of referral information in order to have the information available in case the measurements can not be obtained in the home.  These items will be used in the calculation of BMI, which will be used to determine risk for development of pressure ulcers and will play into agency risk adjustment.

GG0170C:  Mobility – Lying to Sitting on Side of Bed: The ability to safely move from lying on the back to sitting on the side of the bed with feet flat on the floor, and with no back support.

This item can be tricky due to the fact that the options are ranked by dependence levels the opposite of most of the OASIS.  6 is Independent, while with M1860 – Ambulation 1 is Independent!  Agencies should educate to this issue specifically.  There are pages of guidance on assessing the patient in order to respond to this item.

The changes to the pressure ulcer section of the OASIS-C2 data set have undergone some significant changes and we will discuss that in the next blog.

If you are a HPS Alliance Member there will be a free teleconference on November 18, 2016 to cover all the changes.

Click here to register.  Click here to become an Alliance Member.