In response to stakeholder comments, CMS removed four confusing words: "minimal risk for falls" from the new falls risk assessment item, according to the latest changes to the just released OASIS-C1 draft document.
The questions now asks whether the patient was "assessed using a standardized, validated assessment tool." Clinicians expressed confusion over the previous OASIS-C1 draft version of the item that included language indicating "minimal risk for falls," which is not currently used in the MAHC-10 and other commonly used falls risk assessments, including the Time Up and Go (TUG).
That's one of the four major changes that CMS made to the OASIS-C1 document in preparation for the release of the ICD-10 coding set. Agencies will begin using the new OASIS-C1 document on Oct. 1, 2014, in conjunction with the roll-out of the new diagnosis code set.
A total of 27 items were revised in response to comments submitted during the 60-day public comment period that ended Aug. 20. The majority of those changes were minor wording changes or additions to clarify item questions, responses and instructions, CMS stated.
3 more significant changes
- M1033 (Risk for hospitalization). Based on a public comment, response seven was changed from "Currently taking six or more medications" to "Currently taking five or more medications," which is used in OASIS-C. Also, response nine now reads "Other risk(s) not listed in 1-8." In OASIS-C1, the number of answer options for this item was expanded to 10 from seven in OASIS-C.
- M1309 (Worsening in pressure ulcer status since start of care (SOC)/resumption of care (ROC)). CMS changed this new item to accommodate pressure ulcers that are unstageable due to slough/eschar and that are new or previously Stage I or Stage II at the most recent SOC/ROC. Language in response option "d" was added that says: "Unstageable due to coverage of wound bed by slough or eschar." Column 2 from OASIS-C's M1308 (Current number of unhealed pressure ulcers at each stage) is replaced by M1309.
- M2250 (Plan of care synopsis) — Response "d" has been changed in the OASIS-C1 draft to include the phrase, "and/or physician notified the patient screened positive for depression" to allow agencies to receive credit for appropriate interventions that are reported in the process measure "Depression assessment conducted with follow-up plan."
Changes that remain in OASIS-C1 draft
Items in OASIS-C that report diagnoses now have space to enter seven-digit codes, while references to ICD-9 "E" and "V" codes were removed, CMS says.
CMS also made wording changes to 44 items in OASIS-C1, including clarification of data collection time periods and spelling out abbreviations such as "e.g." and "i.e." with clearer language such as "for example" and "specifically."
In addition, CMS eliminated the collection of eight items at various time points, including M1012 (Inpatient procedures). — Nicholas Stern (email@example.com)
Editor's notes: View a crosswalk of the key changes here. Submit comments by Dec. 9 at: https://www.federalregister.gov/articles/2013/11/08/2013-26822/agency-information-collection-activities-submission-for-omb-review-comment-request.
Save the date: DecisionHealth will host a webinar on the changes in the OASIS-C1 draft Feb. 6 from 1:00 to 2:30 p.m. EST. Visit www.decisionhealth.com in the next few days for more details.