Change is never easy, and in the case of home health, changes often come in clusters and are more challenging than ever. But one thing we can count on is change; it is inevitable. How the home health industry prepares for these challenges dictates how we fare long-term. Agencies that prepare and train employees on upcoming changes tend to have increased productivity when changes are implemented. Axxess will continue to keep you informed of changes and plan to provide additional information and/or webinars regarding these OASIS changes.
Recent revisions to the OASIS C data set are now finalized, with implementation of OASIS C1/ICD-9 Version to take place on January 1, 2015.
The OASIS C1/ICD-9 is a revised version of the original OASIS C1 data set, which was set to go into effect with the implementation of ICD-10-CM on October 1, 2014. However, on April 1, 2014, the Protecting Access to Medicare Act (PAMA) of 2014 was enacted which pushed implementation of ICD-10-CM to “no earlier than” October 1, 2015. Since the original OASIS C1 data set was geared for use with the ICD-10-CM code set, a change to OASIS C1 items to accommodate ICD-9-CM codes was necessary. CMS (Center for Medicare and Medicaid Services) made these required changes and named the data set OASIS C1/ICD-9 Version.
Since 5 of the original OASIS C1 data items required ICD-10-CM codes, (M1011, M1017, M1021, M1023, and M1025) the ICD-9 revision removed these items. OASIS C1/ICD-9 replaced the prior listed items with the OASIS C items we are familiar with: M1010, M1016, M1020, M1022, and M1024. With these changes in place, coding can continue with ICD-9-CM codes being used in conjunction with the other OASIS C1 changes until the transition to ICD-10-CM takes place. Once ICD-10-CM is implemented, agencies will use the original OASIS C1 as planned.
The timeline for OASIS changes are as follows:
We will continue to use OASIS C until 11:59pm EASTERN time on 12/31/2014.
We will begin using OASIS C1/ICD-9 at 12:00am EASTERN time on 1/1/2015.
We will begin using OASIS C1 at time of implementation of ICD-10-CM.
Several additional OASIS-C items were deleted and replaced with new item numbers in OASIS C1 and OASIS C1/ICD-9. The replaced items may have minor wording changes, or are completely new items. These include the following items:
|DELETED ITEM #||REPLACEMENT ITEM #||DESCRIPTION||CHANGE(s)|
|M1012||NA||Inpatient Procedures||Completely Deleted|
|M1032||M1033||Risk for Hospitalization||Item wording change; changes to Item Intent and Response-Specific Guidance|
|M1040||M1041||Influenza Vaccine||Item wording change; Skip pattern change; changes to Item Intent and Response-Specific Guidance|
|M1045||M1046||Reason Flu Not Received||Item wording change; changes to Item Intent and Response-Specific Guidance|
|M1050||M1051||Pneumonia Vaccine||Item wording change; changes to Item Intent and Response-Specific Guidance|
|M1055||M1056||Reason PPV not Received||Item wording change; changes to Item Intent and Response-Specific Guidance|
|NA||M1309||Worsening in Pressure Ulcer Since SOC/ROC||New item|
|M1310||NA||Pressure Ulcer Length||Deleted|
|M1312||NA||Pressure Ulcer Width||Deleted|
|M1314||NA||Pressure Ulcer Depth||Deleted|
|M2100||M2102||Types and Sources of Assistance||Item wording change; changes to Response-Specific Guidance|
|M2440||NA||Reason Admitted to a Nursing Home||Deleted|
Staff training ahead of the implementation date of January 1, 2015 is imperative for successful implementation and peak productivity. Agencies can strategize and begin training now in order to be well-trained before implementation of the OASIS C1/ICD-9 data set. Some training ideas include taking a couple of items weekly and teaching the changed terminology. Another training idea is to break down the OASIS C1/ICD-9 into body sections and composing scenarios or pre and post-tests for use when reviewing materials with clinical staff.
For more information on the OASIS C1/ICD-9 Data Set, click on the link below:
For the New OASIS Item Guidance or User Manual, follow the link below: