Assigning Diagnosis Codes Based on the OASIS Report

Posted by admin | April 20, 2017 , (0) comments

Home Health Care







Home health care providers are required to fill out an Outcome and Assessment Information Set (OASIS) form at a patient’s initial appointment, at each 60-day follow up appointment, and at the point of discharge. Providers are required to include a wide range of data on the form, which is used by the Centers for Medicare and Medicaid Services for insurance purposes, as well as by the provider to evaluate and improve the quality of care.

For the form to be filled out properly, the data must be coded in a manner that is consistent with ICD-10-CM. Sometimes, this is done by the provider, but at other times, it is completed by a coding specialist. Whichever is the situation at your home health agency, there are some key things to know about when assigning diagnosis codes based on OASIS form information:

A) ICD-10-CM coding guidelines

The ICD-10-CM coding guidelines are set forth by the National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services (CMS), and they are outlined on the CDC website. Because several legacy coding systems have been retired, it is essential that home health providers follow the most recent guidelines.

B) OASIS Guidance Manual

OASIS form-specific ICD-10-CM coding guidelines are laid out in the OASIS Guidance Manual. This guide was developed by the CMS to outline the process for assigning ICD-10-CM diagnosis codes for certain patient conditions.

C) Documentation consistency

For insurance purposes, it is essential for the diagnosis codes on the health care plan, the OASIS form, and the insurance claim to match. You may want to have these forms reviewed before they are finalized in order to ensure that this is the case, especially if multiple home health workers have played a role in filling out any of these forms.

D) Multiple coding

When a patient’s diagnosis includes multiple elements, it is important to follow ICD-10-CM multiple coding conventions. Specifically, the underlying condition is coded first, and it is followed by the codes for etiological manifestations.

While properly evaluating a patient’s condition is the first line of business for home health providers who are filling out OASIS forms, assigning diagnosis codes in compliance with ICD-10-CM is essential for avoiding problems with insurance reimbursement, as well as for tracking patient care outcomes. For assistance with the process or to get an expert review of your OASIS form, contact AnnexMed today.






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