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Contact Information

Wendy Castro

OASIS Training Coordinator COQS

 wendy.castro@state.co.us

cdphe_oasis_colorado@state.co.us

303-692-2854

Answer to Provider Questions:

1) While a home health agency may use third-party external auditors to review OASIS coding and make recommendations, the assessing clinician is responsible for determining OASIS coding based on their assessment.  Each OASIS item should be considered individually and coded based on the guidance provided for that item.  When a potential inconsistency is identified within the assessment timeframe (including inconsistencies identified by a vendor/consultant/third-party reviewer), the assessing clinician may consider available input from these other sources and determine if any revisions to OASIS item responses is warranted, within the assessment timeframe and consistent with OASIS guidance. 

2) The Symptom Control Rating definitions for M1021/M1023 - Primary Diagnosis/Other Diagnoses were inadvertently omitted from the OASIS Manual and will be replaced in the next version. The definitions are:  0 - Asymptomatic, no treatment needed at this time 

1 - Symptoms well controlled with current therapy 

2 - Symptoms controlled with difficulty, affecting daily functioning; patient needs ongoing monitoring 

3 - Symptoms poorly controlled; patient needs frequent adjustment in treatment and dose monitoring 

4 - Symptoms poorly controlled; history of re-hospitalizations

3) M1830 - Bathing identifies the patient’s ability to bathe their entire body and the assistance that may be required to safely bathe, including transferring in/out of the tub/shower. Select Code 3 if the patient is “Able to participate in bathing self in shower or tub, but requires the presence of another person throughout the bath for assistance or supervision.” If the patient does not require the presence of another person throughout the bath for assistance or supervision, Code 3 is not the appropriate response.  Select Code 2 if the patient is “Able to bathe in shower or tub with the intermittent assistance of another person.” 

4) The intent of GG0100 - Prior Functioning: Everyday Activities is to record the patient’s ability with everyday activities prior to the current illness, exacerbation, or injury.  GG0100A - Self-care identifies the patient’s need for assistance with bathing, dressing, using the toilet, and eating prior to the current illness, exacerbation, or injury.  If the patient required assistance prior to the most recent illness, injury, or exacerbation, to complete any of the GG0100A activities then code 2 - Needed Some Help. If assistance was provided but not required prior to the most recent illness, injury, or exacerbation, and the patient could complete all of the GG0100A activities themself, code 3 - Independent. 

5) Falls that occur due to a medical event, such as a seizure, are considered a fall for the purposes of coding M1033 - Risk for Hospitalization, J1800 - Any Falls Since SOC/ROC, and J1900 - Number of Falls since SOC/ROC. 

6)  M2001 - Drug Regimen Review identifies if a drug regimen review was conducted, and whether any potential or actual clinically significant medication issues were found. A potential (or actual) clinically significant medication issue is defined as a potential or actual issue that, in the clinician’s professional judgment, warrants physician/allowed practitioner (or physician-designee) communication and completion of prescribed/recommended actions by midnight of the next calendar day (at the latest). Any circumstance that does not require this immediate attention is not considered a potential or actual clinically significant medication issue for the purpose of the drug regimen review items. If, in your scenario, the medication alerts triggered by the EMR software do not meet the definition of a potential (or actual) clinically significant medication issue, then they would not be reported as such when coding M2001 - Drug Regimen Review, M2003 - Medication Follow-up, or M2005 - Medication Intervention.