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CMS Proposes Changes to OASIS Integumentary Items

OASIS Answers - Wednesday, August 19, 2015

On July 6th, CMS released the Home Health Proposed Rule for CY 2016 that included proposed changes to the Home Health Quality Reporting Requirements. Outlined in this proposal is one of home health’s first encounters with the IMPACT Act of 2014 via the introduction of a standardized cross-setting measure in the skin integrity domain.

The proposed measure is titled Percent of Residents or Patients with Pressure Ulcers that are New or Worsened and is calculated from OASIS data. In the spirit of the IMPACT Act’s goal of standardized patient assessment data and quality measures across post acute care settings, changes to the OASIS data set are being proposed to align with the data sets of our PAC partners.

Proposed OASIS data set changes for CY 2017 include the addition of items allowing risk adjustment of the pressure ulcer measure (including reporting of height and weight to allow calculation of BMI, and reporting of  PVD, PAD and DM as active diagnoses.) Additionally, changes to existing OASIS items M1308 – Current Number of Unhealed Pressure Ulcers at Each Stage or Unstageable, and M1309 Worsening in Pressure Ulcer Status since SOC/ROC are being proposed.

Providers can view the proposed measure specifications, along with the proposed changes to the OASIS Integumentary domain, and submit comments to CMS online at until September 4th.

Thank you for adding your expertise and insight to these quality improvement efforts intended to benefit our home care patients.


Linda Krulish, PT MHS COS-C 
President, OASIS Answers, Inc.

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It's ICD-10 Dual Coding Time!

OASIS Answers - Wednesday, August 05, 2015

The October 1, 2015 implementation of ICD-10-CM is quickly approaching.  This week marked an important milestone in the countdown to October 1 as many home health agencies implemented dual coding using ICD-9-CM and ICD-10-CM.   Because of the 60-day payment episode, a patient admitted on August 3, 2015 through September 30, 2015 will have the Request for Anticipated Payment (RAP) submitted with ICD-9-CM diagnosis codes.  If the patient’s dates of service span through October 1, 2015 or later, the home health agency must submit the end of episode (EOE) claim with ICD-10-CM diagnosis codes. In order to assure an uninterrupted billing cycle, The Centers for Medicare and Medicaid Services (CMS) recommends the RAP be dual coded with both ICD-9-CM and ICD-10-CM codes, transmitting only the ICD-9-CM codes. The EOE claim occurring on or after October 1 will transmit only the ICD-10-CM codes.

For hospice agencies, the transition to ICD-10-CM is based on the date of service or for hospice the benefit period.  For services performed on or after October 1, 2015 the claim must contain ICD-10 diagnosis codes.  Because the diagnoses are defined at the beginning of the benefit period, it was recommended hospice agencies start dual coding for benefit periods beginning July 4, 2015 through September 30, 2015.  The rationale is the benefit period will span the October 1, 2015 date. Depending solely on the GEMS may result in overuse of “general” codes rather than the specific codes that are needed. This could result in issues with coding integrity and accuracy leading to a negative impact on the agency’s quality and financial outcomes. 

Important reminder…It is not too late to register for the MLN Connects National Provider Call: Countdown to ICD-10 scheduled for Thursday, August 272:30-4 pm ETTo Register: Visit MLN Connects Event Registration

CMS Acting Administrator Andy Slavitt will be opening the call with a national implementation update. Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will be joining the call with coding guidance and tips, along with updates from CMS. 

Utilize available resources from CMS and other reputable sources to work the plan your organization has outlined to keep on track as we head toward the October 1st date. Then recognize the work is not over. Support your coders by ensuring they have necessary coding references and education to do the job right!

ICD-10… We've Got This! 


Bobi Rose RN BSN CWCN CCCN COS-C               Sparkle Sparks PT MPT HCS-D COS-C
OAI Senior Consultant                                                               OAI Senior Associate Consultant

CMS Posts HIS Manual Update Video Modules for Download

OASIS Answers - Monday, August 03, 2015

CMS has organized their most recent MLN presentation regarding updates to the Hospice Item Set (HIS) manual from V1.01 to V1.02 into 4 modules.  These modules can assist you in educating your team -- individuals can listen to the specific modules that directly affect their work.

  • Module 1 & 2 overview can be used for the entire hospice IDG. 
  • Module 3 is helpful for staff involved in administrative information and record completion and retention.  
  • Module 4 focuses on the care processes that would benefit your clinicians. 

Each of the modules run approximately 15-20 minutes for focused attention. 


Module 1 provides an overview of the updates and clarifications to the Hospice Item Set (HIS) Manual V1.02. This video also provides a general background of the Hospice Quality Reporting Program (HQRP).


Module 2 provides updates to Chapter 1 of the Hospice Item Set (HIS) Manual v1.02 including background and overview.


Module 3 provides information on Section A (Administrative Information) and Section Z (Record Administration) in the Hospice Item Set (HIS) Manual v1.02.


Module 4 provides information on the Hospice Item Set (HIS) Manual v1.02: Care Process Items Sections F (Preferences), J (Pain/Respiratory Status), and N (Medications). 

Click here to download the latest HIS Manual.

Are you concerned that potentially bad habits related to HIS collection may develop in your organization ? Join OASIS Answers for a one-day HIS Training Workshop to ensure your knowledge and practice is consistent with current CMS guidance and expectations. The next available session is November 10th in Columbus, OH. Read more about HIS training here. You may register by going to the HIS event page in our store.  Need training sooner? Contact us to arrange HIS training via webinar for your organization by emailing

Thanks for contributing to the success of the Hospice Quality Reporting Program through your commitment to HIS accuracy.


Dodie Johnson, RN MSN AGNP-C
Senior Consultant
OASIS Answers, Inc.

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