TECHNICAL INFORMATION - PowerPoint Presentation

TECHNICAL INFORMATION AND CHANGES TO OASIS-C 1

Error Summary Report Effective Dates BETWEEN 07/01/2013 AND 06/30/2014 2

Error Code 286Inconsistent M0090/Submission Date: The submission assessment was not submitted within CMS timing guidelines. The submission date is more than 30 days from the M0090 (Completion Date). Number of errors = 29306 % of Assessments with the Error = 7.32% 3

Error Code 1002Inconsistent record sequence: The submitted record does not satisfy the sequence guidelines. The submitted (M0100) does not logically follow the (M0100) previously accepted by the state system. Number of errors = 7356 % of Assessments with the Error = 1.84% 4

Error Code 1003Inconsistent effective date sequence: Record does not meet sequence guidelines. Effective date of this record submitted is a date earlier than effective date of the most current record in the system. Number of errors = 4660 % of Assessments with the Error = 1.16% 5

Error Code 129Inconsistent M0090 date: Discharge record was not completed within CMS timing guidelines. (M0090) date should be no earlier than (M0906) date AND no more than the 2 days after (M0906) date. Number of errors = 3367 % of Assessments with the Error = 0.84% 6

Error Code 262Inconsistent M0090 date: RFA 04 (M0090) does not meet CMS timing guidelines. RFAs 04 must be done on an every 60 day cycle; (M0090) is no earlier than day 56 and no later than day 60 of that follow up cycle. Number of errors = 2654 % of Assessments with the Error = 0.66% 7

Error Code 320The submitted HIPPS_VERSION must match the calculated HIPPS_VERSON value. Number of errors = 2340 % of Assessments with the Error = 0.58% 8

Error Code 265New Patient: A new person has been created in the database of the CMS OASIS system at the State with the information submitted in this record. Number of errors = 1556 % of Assessments with the Error = 0.39% 9

Error Code 257The submitted HIPPS_CODE must match the calculated HIPPS_CODE value. Number of errors = 677 % of Assessments with the Error = 0.17% 10

Error Code 109Inconsistent M0032 date: The submitted assessment M0032 date was late. The M0032 date should be no earlier than the M1005 (M0180) most recent inpatient discharge date AND no more than 14 days after the M1005 (M0180) date. Number of errors = 202 % of Assessments with the Error = 0.03% 11

Error Code 104Inconsistent M0030 date: The assessment was not completed within CMS timing guidelines. The M0030 date should be no earlier than the M1005 (M0180) most recent inpatient discharge date AND no more than 14 days after the M1005 (M180) date. Number of errors = 186 % of Assessments with the Error = 0.02% 12

Error Code 108Inconsistent M0090 date: The assessment was not completed within CMS timing guidelines. The (M0090) date should be no earlier than the (M0032) date AND no more than 2 days after the (M0032) date. Number of errors = 129 % of Assessments with the Error = 0.03% 13

Error Code 103Inconsistent M0090 date: The assessment was not completed within CMS timing guidelines. The (M0090) date should be no earlier than the (M0030) date AND no more than 5 days after the (M0030) date. Number of errors = 56 % of Assessments with the Error = 0.01% 14

Error Code 287Inconsistent M1020 (M0230) Primary diagnosis ICD code/M1020 (M0230)Severity Rating: The Severity Rating for the Primary Diagnosis should not be “00”. Number of errors = 20 % of Assessments with the Error = 0.00 % No. of error too small to calculate a percentage 15

Error Code 281Inconsistent M0016 data: The Branch ID submitted in this assessment does not match the current Branch ID in the State database. Number of errors = 18 % of Assessments with the Error = 0.00% No. of error too small to calculate a percentage 16

Error Code 52Field left justified: The submitted data in the above field was not left justified. Accepted record has been modified (left justified). Verify justification with your software vendor. Number of errors = 18 % of Assessments with the Error = 0.00% No. of error too small to calculate a percentage 17

Error Code 303 Inconsistent M1022 (M0240)/M1024 (M0246) values: If M1024 (M0246) Case mix diagnosis primary ICD B3 - F3 or M1024 (M0246) Case mix diagnosis ICD B4 – F4 is not blank then the corresponding M1022 (M0240) Other diagnosis ICD code field should be a V-code. Number of errors = 3 % of Assessments with the Error = 0.00% No. of error too small to calculate a percentage 18

Error Code 302Inconsistent M1020 ( M0230)/M1024 (M0246) values: If M1024 ( M0246) Case mix diagnosis primary ICD, column 3 or M1024 (M0246) Case mix diagnosis primary ICD, column 4 is not is not blank then M1020 ( M0230 ) primary diagnosis ICD code should be a V-code. Number of errors = 2 % of Assessments with the Error = 0.00% No. of error too small to calculate a percentage 19

Error Code 294Inconsistent NPI: The NPI number submitted in this record is not consistent with the NPI number submitted in the header record. Number of errors = 2 % of Assessments with the Error = 0.00% No. of error too small to calculate a percentage 20

ASAP (Assessment Submission and Processing System)Effective January 1, 2015, OASIS assessment data will be submitted to CMS via the national OASIS ASAP. With the implementation of the OASIS ASAP system, Home Health Agencies will no longer submit OASIS assessment data to CMS via their state databases. 21

ASAPOASIS submissions to the state system will discontinue starting at 6:00 p.m. ET on December 26, 2014 through December 31, 2014 at 11:59 p.m. (ET). No OASIS assessments will be accepted. The HHA state submission system will no longer be used for OASIS submissions. New, modification, or inactivation records in the current flat file format must be submitted prior to 6:00 p.m. ET on December 26, 2014. 22

ASAPThe OASIS ASAP system will be available at 12:00 a.m. ET on January 1, 2015 . Data collected during this time period (December 26, 2014 and December 31, 2014), may be submitted on or after January 1, 2015 using the ASAP system. 23

ASAPFiles submitted on or after January 1, 2015 must follow version 2.10 (which supports OASIS-C) and version 2.11 (which supports OASIS-C1) of the OASIS data submission specifications. 24

ASAPIf providers have any missing discharge assessments, providers should submit their missing discharge assessments prior to September 26, 2014. Effective October 1, 2014, all records greater than 36 months for an active agency and 24 months for a closed agency (based on the M0090 date to submission date) will be rejected. 25

ASAPWith the new ASAP system, providers will have to update their OASIS HIV and STD flags (ASAP has 2 separate flags) and enter their prohibited ICD codes for both ICD-9 and ICD-10 on the ASAP system. 26

Payment Grouper UpdatesAn updated home health payment grouper will be provided to accommodate data submitted on or after October 1, 2014 using the OASIS-C data item set and ICD-9-CM codes. An updated home health payment grouper will be provided to accommodate assessments data submitted January 1, 2015 and later using the OASIS-C1 and ICD-9-CM codes. 27

Payment Grouper UpdatesGrouper Update #1 – To be implemented on October 1, 2014 for use with assessments submitted on October 1, 2014 and thereafter. Grouper Update #2 - To be implemented on January 1, 2015 for use with assessments submitted on January 1, 2015 and thereafter. Grouper Update #3 – To be implemented on October 1, 2015 for use with assessments submitted on October 1, 2015 and thereafter. 28

Data SubmissionIf a HHA identifies an error such as a patient’s social security number after having submitted several assessments containing that error, an inactivation process retroactively will not correct all the erroneous submissions. Each assessment submitted to the State system containing the error must be individually inactivated and a corrected original assessment submitted in its place. It is important to note that an inactivation request inactivates only a single record. Both the inactivation request and the replacement record may be included in the same submission batch. 29

Data SubmissionFor all types of assessments, the timeframe during which encoding, editing, and locking must occur is seven calendar days from the completion of the assessment. Once the OASIS data is collected, agencies have 7 days to encode (enter into a computer) their OASIS data, check the data for errors and make the assessment export ready. At least once a month, agencies should have all of the locked (export ready) assessments waiting for submission and create a file to send to the State agency. The OASIS reporting regulations requires transmission at least monthly. 30

Changes to Be Made to OASIS-C1 to Create “OASIS-C1/ICD-9 Version” 31

OASIS Item M1010/M1011M1011 contains ICD-10 terminology and formatting. M1011 is deleted and replaced with M1010, the current approved OASIS-C item using ICD-9. 32

M1016/M1017M 1017 contains ICD-10 terminology and formatting. M1017 is deleted and replaced with M1016, the current approved OASIS-C item using ICD-9. 33

M1020/M1023/M1025M1021, M1023, M1025 contains ICD-10 terminology, formatting and instructions. M1021, M1023, M1025 are deleted and replaced with M1020, M1022, M1024, the current approved OASIS-C items using ICD-9. 34

Reason for ChangeM1010, M1011, M1016, M1017, M1020, M1023, M1025 were changed to necessitate the removal of OASIS-C1 items containing ICD-10 specific terminology, formatting, and instructions. Items currently in use in OASIS-C that have ICD-9 specific references, formatting, and instructions have been substituted. 35

Time Points TableOASIS-C1 with ICD-10 included “M1011” at Follow-Up Time Point. OASIS-C1/ICD-9 Version deleted at Follow-Up Time Point. The reason is Protecting Access to Medicare Act of 2014 (PAMA) necessitates the removal of ICD-10 specific items in the Time Points Table. The ICD-9 version of this item is not collected at Follow-Up in OASIS-C and therefore will not be included in OASIS-C1. 36

Time Points TableOASIS-C1 with ICD-10 included “ M1021 ” at Follow-Up Time Point. OASIS-C1/ICD-9 Version is deleted at Follow-Up Time Point and “M1020” substituted. The reason is PAMA necessitates the removal of ICD-10 specific items in the Time Points Table and replacement with the substituted ICD-9 specific items. 37

M1000OASIS-C1 with ICD-10 Instructions for response NA now state, “Go to M1017.” OASIS-C1/ICD-9 Version Instructions for response NA now state: “Go to M1016.” The reason is PAMA necessitates the removal of ICD-10 specific items. Therefore, instructions to use ICD-10 specific items in the M1000 Skip instructions must be replaced with instructions to use the substituted ICD-9 specific items. 38

M1340OASIS-C1 with ICD-10 For response options 0 and 2, directions read “At TRN/DC, go to M1400.” OASIS-C1/ICD-9 Version For response options 0 and 2, directions changed to “At FU/DC, go to M1400” because item is collected at Follow-up and Discharge, not Transfer (TRN). 39

M1340M1350 was deleted at Follow-up and Discharge as part of OASIS-C1 burden reduction. Directions to skip M1350 at Follow-up were inadvertently omitted from M1340. 40

When should providers begin to use the OASIS-C1/ICD-9 data set?The M0090 date for all assessments (SOC, ROC, Recertification, Other Follow-Up, Transfer, Death at Home and Discharge) determines which version of OASIS must be completed. If the M0090, Date Assessment Completed is 12/31/2014 or before, use the OASIS-C data set. If the M0090, Date Assessment Completed is 01/01/2015 or after, use the OASIS-C1/ICD-9 data set. 41

When should providers begin to use the OASIS-C1/ICD-9 data set?If an assessment is completed on or before 12/31/2014 utilizing the OASIS-C data set and the assessing clinician chooses to reassess one or more OASIS items on or after 01/01/2015 during the allowed timeframe for data collection (for example: within 5 days after the SOC, within 2 days after the ROC or DC), this would change the M0090 date and the OASIS-C1/ICD-9 data set must be completed instead of the OASIS-C. 42

CMS TrainingThe OASIS-C1/ICD-9 webinar being hosted by CMS has been rescheduled for September 3, 2014 at 1:00 – 3:00 p.m . (ET). Questions related to OASIS-C1/ICD-9 have to be submitted prior to the date of the webinar. There will not be a “live” questions and answers during the webinar. 43

ResourcesInformation regarding OASIS C1 Draft Chapter 3, OASIS C1/ICD-9 Data Set, OASIS C1 to OASIS C1/ICD-9 Change Guide and the OASIS revised questions and answers can be found at: http :// www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html or http:// www.oasisanswers.com/aboutoas_links. htm#qAndA 44

SourcesThe Error Summary Report http:// www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/OASIS-C1.html Quarterly Questions and Answers (December 2012 through July 2014) 45

Madeline Coleman, RN, MS, JD, CPHQManager, Quality Improvement and OASIS Coordinator 665 Mainstream Drive Nashville, TN 37243 madeline.coleman@tn.gov 615-741-7534 Contact Information 46