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Tuesday, December 16, 2014

New OASIS C1/ICD-9 version to begin January 1, 2015: Are you ready?

ICD-9, ICD-10
ICD stands for international classification of diseases
By Andrew Fujii

Hopefully you’ve been doing your due diligence and preparing for all of the changes that are imminent with the upcoming implementation of ICD-10. If you haven’t been, you may have dodged the proverbial bullet.

ICD-10 was delayed, meaning the Protecting Access to Medicare Act of 2014 (PAMA) was enacted on April 1, 2014. This states that ICD-10 cannot to be adopted prior to October 1, 2015. This delay caused the delay of the new OASIS C1 which had been scheduled for implementation on October 1, 2014.

The reason that ICD-10’s delay caused the delay of the new OASIS C1 data set, is due to the fact that five of OASIS C1’s data items require ICD-10 codes. Without these codes the data set would result in a lot of errors.

Therefore a new data set was constructed that combined elements of both versions. This hybrid is known as OASIS C1/ICD-9. In this new data set ICD-10 specific items will be replaced with the original ICD-9 counterparts.

Getting ready for the transition is no easy feat. There are a lot of moving parts that have been made more confusing due to the delays. Understanding the different changes and revisions will help your team better prepare for new OASIS C1/ICD-9 implementation. Make sure that your staff understands the timeline, the initial changes from OASIS C to OASIS C1, and the five ICD-10 codes that are being replaced in the hybrid data set.

The Timeline

In order to prepare for the new OASIS C1/ICD-9, it is important to get a clear picture of the timeline that will be used. The most prominent date to remember is January 1, 2015 when the new version officially takes over. However, there are other dates that will surely be important to all staff members as it relates to how and which data to process.
  • OASIS submissions to the state discontinues: December 26, 2014 - 6:00 am EST
    • Home health agency state submissions will no longer be used for OASIS submissions
  • Use of OASIS C continues until: December 31, 2014 - 11:59 pm EST
  • Use of OASIS C1/ICD-9 begins: January 1, 2015 - 12:00 am EST
  • OASIS assessment data submitted to CMS via Assessment Submissions and Processing System (ASAP): January 1, 2015
  • For all M0090 assessments, the new OASIS C1/ICD-9 version is to be used: January 1, 2015
  • OASIS C1 begins at the time of implementation of ICD-10-CM.

OASIS C Changes

A handful of OASIS C items were altered in the new OASIS C1 and OASIS C1/ICD-9 versions. Understanding and taking into account these changes will help prepare you for the upcoming transition. The following table outlines those changes:

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

ICD-10 replacements

The ICD-10 specific items will be replaced with their ICD-9 counterparts as stated earlier. The five codes affected are M1011, M1017, M1021, M1023, M1025. These five codes will be important as you adopt the new hybrid OASIS C1/ICD-9 version.
  • M1010 (inpatient diagnosis) will be used instead of M1011
  • M1016 will be used instead of M1017
  • M1020, M1011, and M1024 will be used instead of M2021, M1023, and M1025

Staff training

In order to transition smoothly to the new hybrid version beginning in the new year, it is vital that you staff be made aware and trained regarding the modifications. Additionally, your staff should review the information on the Centers for Medicare and Medicaid Services website, such as the OASIS User Manual.

Additional information about the OASIS C1/ICD-9 data set can also be found on the CMS website.

About the author: Andrew Fujii is a marketing professional with expertise in digital/web and content marketing. He is also a copywriter for multiple agencies producing copy for blogs, articles, websites, product packaging, mobile apps, and more.

Image:  Przesłany przez użytkownika Luk4ward,"ICD9 Codes Logo"; CC BY-SA 3.0