CMS Updates on OASIS-C1 and Hospice

Centers for Medicare & Medicaid Services (CMS) announce changes to OASIS-C1 Implementation

Next week, Sept. 3, starting at 2 p.m. EST, CMS will host a webinar on OASIS-C1/ICD 9 issues. This webinar will include:

• The impact of the delay of ICD-10 on the implementation of OASIS –C1;
• Types of changes made to the data set;
• OASIS-C1/ICD-9 Manual changes; and
• OASIS Q&A updates.

Please note page three of the CMS announcement for the logistics on how to join the webinar.

CMS Issues a Manual Update for Hospice

CMS has issued Change Request (CR) 8877 which implements the "debility" and "adult failure to thrive" and dementia codes classified as unspecified editing. According to CR 8877, the principal diagnosis reported on the claim should be the diagnosis most contributory to the terminal prognosis. “Debility” (799.3, 780.79/R53.81) and “adult failure to thrive” (783.7/R62.7) are not to be used as principal hospice diagnoses on the hospice claim form. When any of these diagnoses are reported as a principal diagnosis, the claim will be returned to the provider for a more definitive hospice diagnosis based on ICD-9-CM/ICD-10-CM Coding Guidelines.

This CR also includes the policy that hospices must submit Notice of Elections (NOEs) within five calendar days after the hospice election, and an exception process when a NOE is not fielded timely. 

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871