Archive for June 15th, 2010

June 15, 2010

Those six OASIS slots, POC and patient diagnoses

I often hear frustration in trying to identify all of a patient’s diagnoses in the six OASIS slots, especially when multiple coding is required. It is tough to show the patient’s condition, but remember that the OASIS is just part of the comprehensive assessment. From that full assessment you will have the diagnoses that represent your patient’s condition. These conditions are listed in several places:

OASIS: The one we focus on the most, as this is the payment area. You need to code in the order that reflects the seriousness of the patient’s condition and what skilled services are provided, NOT for reimbursement.

Plan of Care: Your Plan of Care should list all of the patient’s pertinent diagnoses, and most POCs have room for a large number of diagnoses. Important: Anything you list in M1024 must be listed somewhere in the Plan of Care, included resolved diagnoses that appear in M1024. Those resolved M1024 diagnoses can be noted in Field 21, but that specific field number is my suggestion, not a requirement. There are other places to note these diagnoses, and they must be listed.

The Claim: Your claim should have nine slots for diagnoses. Again, make sure all of these are on your Plan of Care.

All diagnoses much match up across these three listings.

Sometimes coders will ask if if CMS will expand the number of slots on the OASIS for coding. I don’t know of any discussion within CMS to increase the number of diagnoses.