Bone Up on OASIS C to Enhance Your Home Health Coding

For maximum payoff, combine correct coding with OASIS C accuracy.

With all the attention on OASIS C process measures and communications requirements, correct coding can get lost in the shuffle. So now more than ever it is important to correctly document all the factors and co-morbidities that can have an effect on the care you provided on the OASIS. However precise diagnosis coding is just one part of the riddle.

Prior to OASIS C, it was somewhat easier to see how the diagnosis codes you select would have an effect on your agency's reimbursement. Now, coding by itself does not often make the difference in dollars, according to Jan McLain, RN, BS, LNC, HCS-D, COS-C with Adventist Health System Home Care in Port Charlotte, Fla. In its place, code selection and correct OASIS scoring - both supported by clinical documentation merge to present a solid picture of the care you provide.

Interaction: McLain says, "What I see very often is that the OASIS scoring makes the difference in dollars - and it is the OASIS scoring and the clinical documentation that help me aware of the codes listed by the clinician are not the most specific or appropriate." Watch closely at the information gathered in these three areas combined to ensure accuracy, right reimbursements, and a decrease in additional documentation requests (ADRs). With OASIS C, the common sense and integration of all the information provided is what ensures correct payments, she adds.

Medical coders must do more than coding

As an experienced hand, you should ensure that your agency is in compliance with all of the coding regulations and that each episode is fully coded up front to best describe the patient's actual health status, according to Judy Adams, RN, BSN, HCS-D, COS-C, president and CEO of Adams Home Care Consulting in Chapel Hill, N.C. You should try to capture all of the payment your agency is entitled to receive and see to it that the coding matches the OASIS, plan of care, and bill.

However you will need to do more than coding. You should keep a tab and corroborate the OASIS responses against the clinical record and plan of care to be sure everything is consistent and justified, says Adams. The added review ensures the accuracy of the OASIS information which is used to figure out outcomes.

Taking a more comprehensive approach that combines looking at the codes and OASIS scores along with the medical record prevents ADR's, and prevents the added costs of canceling requests for anticipated payment (RAPs) and rebilling episodes.

Jan Mater-Cavagnero MA, HCS-D, specializes in diagnosis coding for home health agencies, as well as the wide variety of issues that impact the hospice industry. Jan is an editor-in-chief for Eli Healthcare, where she has written Home Health ICD-9 Alert for five years.

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