OASIS Tip and Coding Scenarios; January 12, 2015

Good morning, from Quality in Real Time. Are you ready to start your New Year off with coding and OASIS practice? Each week I’ll be sending out an OASIS C1/ICD-9 question and an ICD-9 and ICD-10 coding scenario. Take the time to work through each of these scenarios and check your answers with next week’s blog post. Let’s begin!

OASIS C1/ICD-9

M1041 (Influenza vaccine data collection period) This item is being marked incorrectly quite a bit during the first half of this month with the change from M1040 to M1041. No longer is the question asking if patient received vaccine from your agency, but Does the episode of care include ANY dates on or between October 1 and March 31? It doesn’t make a difference if your agency administered the vaccine for M1041, only whether the patient received it. A care episode includes both a SOC/ROC and Transfer/Discharge and the only time you’ll complete this item is at Transfer or Discharge. If no part of the episode fell within the time period, mark “No” and skip to item M1051.

CMS has already addressed a Q&A to this M00 item:

Q62.2.2. M1041. When completing M1041, Influenza vaccine, what response option is correct if we gave the flu vaccine on Sept. 15th and there was a Transfer date (M906) of Sept. 20th, but the date of Transfer OASIS was completed (M0090) was October 2nd?

 A62.2.2. Patients that did not receive care, (or have any days of their care episode occur) between October 1 and March 31 are excluded from the computation of the influenza process measures. The care episode begins with M0030/M0032 SOC/ROC date and ends with the Discharge/Transfer date, M0906. In your scenario, the appropriate response for M1041, Influenza Vaccine, would be “NA” as the patient was transferred (M0906) on September 30th.

ICD-9-CM Scenario

A patient is admitted to home health with one Stage 4 pressur eulcer on the buttock that was recently treated with a muscle flap, is showing early/partial granulation and is the focus of care. The patient also has a Stage 3 pressure ulcer on the hip. Skilled nursing will perform wound care. Tip to remember: the OASIS may not always match the coding.

ICD-10-CM

A 71-year-old man has multiple stasis ulcers on both ankles and both calves. One on his right ankle includes muscle necrosis, the others are limited to skin. All are infected with MRSA and VRSA. Care is directed at the ulcers, including wound care and IV administration for antibiotics.

Until next week,

Kimberly

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