1Patient Tracking OASIS-C Contact: Cindy Skogen, RN (OEC) , orfor questions.Source: Center for Medicare and Medicaid ServicesThe items in this section can be included on a separate Patient Tracking Sheet, if the agency chooses. These are typically items that don’t change very often. If the items are pulled from the comprehensive assessment and included on a separate Patient Tracking Sheet, the clinician will need to remember to go back to the tracking sheet and update when needed. Example, at each ROC, the M0032 date will need to be updated.
2M0010 CMS Certification Number __ __ __ __ __ __Agency’s CMS Certification NumberIf not Medicare-certified – leave blankThis is NOT the provider’s NPI numberPreprinting on clinical documentation allowed and recommended
3M0014 Branch State (M0014) Branch State __ __State where the agency branch office is locatedLeave blank if:Agency has no branches or if you are the parent agency
4M0016 Branch ID Number (M0016) Branch I D Number __ __ __ __ __ __ __ __ __ __Branch ID code, as assigned by CMSNo branches, enter "N" followed by 9 blank spaces.A parent HHA that has branches, enter "P" followed by 9 blank spaces.Preprinting this number on clinical documentation is allowed and recommended.If ID code listed in M0016, then M0014 cannot be blank
5M0018 National Provider Identifier (M0018) National Provider Identifier (N P I) for the attending physician who has signed the plan of care __ __ __ __ __ __ __ __ __ __⃞ UK – Unknown or Not AvailableNational Provider Identifier (NPI) for the physician who will sign the POCReplaces UPIN of "Primary Referring Physician ID"
6M0020 Patient ID Number (M0020) Patient I D Number __ __ __ __ __ __ __ __ __ __ __ __ __Agency-specific patient ID used for agency recordkeeping for this episode of careMay stay the same from one admission to the nextMay change with each admissionShould remain constant throughout a single episode of care, e.g. SOC – DCLeave spaces at the end blank
7M0030 Start of Care Date (M0030) Start of Care Date: __ __ /__ __ /__ __ __ __ month / day / yearDate the first reimbursable service deliveredIf HHA policy/practice is for RN to perform SOC assessments in therapy only casesThe RN assessment must be same day or within 5 days after the therapy provides billable serviceUsed as part of the PPS logic. Also used for Quality Measures.
8M0032 ROC Date (M0032) Resumption of Care Date: __ __ /__ __ /__ __ __ __ month / day / year⃞ NA – Not ApplicableResumption of Care Date (ROC)Date of first visit following an inpatient stay by patient currently on serviceROC date must be updated on Patient Tracking Sheet (PTS) for each ROC
9M0032 NA at SOC The most recent ROC should be entered HHAs who always DC patients when admitted to inpatient facility will not have a ROC dateCMS Q & A October 2010Question 2: New text in the Medicare Claims Processing Manual, CMS Publication 100-4, Chapter 10, reads, “A beneficiary does not have to be discharged from home care because of an inpatient admission. If an agency chooses not to discharge and the patient returns to the agency in the same 60-day period, the same episode continues. However, if an agency chooses to discharge, based on an expectation that the beneficiary will not return, the agency should recognize that if the beneficiary does return to them in the same 60-day period, the discharge is not recognized for Medicare payment purposes. All the home health services provided in the complete 60-day episode, both before and after the inpatient stay, should be billed on one claim." Does this mean that providers should never do an RFA7 (Transfer with discharge)? CMS OCCB Q&As – October 2010 (www.oasiscertificate.org) Page 2 of 6 Answer 2: When a patient is transferred to the inpatient facility, it should be assessed if the agency anticipates the patient will be returning to service or not. If the HHA plans on the patient returning after their inpatient stay, the RFA6 should be completed. There will be times when the RFA7 is necessary to use, but only when the HHA does NOT anticipate the patient will be returning to care. There are several reasons why the RFA7 may be used, including these examples: the patient needs a higher level of care and no longer appropriate for home health care, the patient’s family plans on moving the patient out of the service area, or the patient is no longer appropriate for the home health benefit.The Claims Processing Manual clarified this issue in July 2010, and directs providers to not discharge a patient when goals are not met at the time of a transfer. If a provider does discharge and readmit within the same payment 60-day episode, a Partial Episodic Payment (PEP) adjustment will be automatically made.
10M0040 Patient Name __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __(First) (M I)__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __(Last) (Suffix)Enter name exactly as it appears on Medicare or other insurance cardPatient’s legal nameSequence of the names may be reorderedUpdate PTS if change occurs during episode
11M0050 Patient State of Residence __ __Where the patient is CURRENTLY residing while receiving home careEven if not usual or legal residenceUpdate PTS if change occurs during episode
12M0060 Patient Zip Code (M0060) Patient Zip Code __ __ __ __ __ __ __ __ __Zip code for address where patient is receiving home careCURRENT residence, even if not usual or legal residenceUsed on Home Health Compare to determine where HHA provided serviceEmphasize how important accuracy is to quality reporting on Home Health Compare.
13M0063 Medicare Number(M0063) Medicare Number: __ __ __ __ __ __ __ __ __ (including suffix)⃞ NA – No MedicareFor Medicare (MC) patients onlyUse RRB number for railroad retirement programEnter claim number from MC cardMay or may not be Social Security numberNo MC, mark “NA-No Medicare”
14M0063 Medicare NumberIf MC HMO, another MC Advantage plan or MC Part CEnter MC number if availableIf not available, mark “NA-No Medicare”Do NOT enter the HMO ID numberLeave spaces at the end blank
15M0064 Social Security Number __ __ __ - __ __ - __ __ __ __⃞ UK – Unknown or Not AvailableInclude all nine numbersMark “UK” if unknown or not availableInformation cannot be obtainedPatient refused to provide information
16M0065 Medicaid Number (M0065) Medicaid Number __ __ __ __ __ __ __ __ __ __ __ __ __ __⃞ NA – No MedicaidSpecifies the patient’s Medicaid (MA) #No MA coverage or MA coverage pending, mark “NA - No Medicaid.”If patient has MA, complete item whether or not MA is reimbursement source for the home care episode.Number assigned by individual stateFound on the patient's Medicaid card
17M0066 Birth Date (M0066) Birth Date: __ __ /__ __ /__ __ __ __ month / day / yearMonth, day, and four digits for the yearE.g., May 4, 1930 = 05/04/1930Item necessary for computation of quality outcomes
18M0069 Gender (M0069) Gender: ⃞ 1 - Male ⃞ 2 - Female The easiest OASIS M item1 - Male2 - Female
19M0140 ⃞ 1 - American Indian or Alaska Native (M0140) Race/Ethnicity: (Mark all that apply.)⃞ 1 - American Indian or Alaska Native⃞ 2 - Asian⃞ 3 - Black or African-American⃞ 4 - Hispanic or Latino⃞ 5 - Native Hawaiian or Pacific Islander⃞ 6 - WhiteInstructional GuidanceInstructions to Class
20M0140 Race/EthnicitySpecifies groups or population to which the patient is affiliatedAs identified by the patient or caregiver (CG)Used for tracking disparitiesIf the patient does not self-identifyReferral informationHospital or physician office clinical recordObservation
21M0140 Race/Ethnicity (cont.) Response 1: American Indian or Alaska Native.Origins in any of the original peoples of North, South America & Central AmericaMaintains tribal affiliation or community attachment.
22M0140 Race/Ethnicity (cont.) Response 2: Asian.Origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinentExamples: Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
23M0140 Race/Ethnicity (cont.) Response 3: Black or African AmericanOrigins in any of the black racial groups of Africa.Terms such as “Haitian”, “Negro”, “Black” or “African American”
24M0140 Race/Ethnicity (cont.) Response 4: Hispanic or Latino.Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race."Spanish origin," can be used in addition to "Hispanic or Latino."
25M0140 Race/Ethnicity (cont.) Response 5: Native Hawaiian or Other Pacific Islander.Origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific IslandsResponse 6: White.Origins in any of the original peoples of Europe, the Middle East, or North Africa.
26M0150*(M0150) Current Payment Sources for Home Care: (Mark all that apply.)⃞ 0 - None; no charge for current services⃞ 1 - Medicare (traditional fee-for-service)⃞ 2 - Medicare (HMO/managed care/Advantage plan)⃞ 3 - Medicaid (traditional fee-for-service)⃞ 4 - Medicaid (HMO/managed care)⃞ 5 - Workers' compensation⃞ 6 - Title programs (e.g., Title III, V, or XX)⃞ 7 - Other government (e.g., TriCare, VA, etc.)⃞ 8 - Private insurance⃞ 9 - Private HMO/managed care⃞ Self-pay⃞ Other (specify) _____________________⃞ UK - Unknown*If responses 1, 2, 3, and/or 4 are checked, Medicare certified HHAs must complete and transmit OASIS per CoP requirementsInstructional GuidanceInstructions to Class
27M0150 Current Payment Sources Limited to identifying payers to which any services provided during this home care episode and included on the plan of care will be billed by your home care agencyMust be accurateAssessments for MC and MA patients are handled differently than for other payersEmphasize this reports just payers to which any services provided during this home care episode and included on the plan of care will be billed by your home care agency - Not every payer they have
28M0150 Current Payment Sources Mark all current pay sourcesPrimary or secondaryExclude “pending” pay sourcesMultiple payers reimbursing for careInclude all sources, e.g., MC, MA, private insurance, self-payIf one or more payment sourcesInclude known, NOT uncertain ones
29M0150 Current Payment Sources Do not consider any equipment, medications, or supplies being paid for by the patient, in part or in fullResponse 2 - MC HMO, another MC Advantage Plan, or MC Part C.Response 3 - MA waiver or home and community-based waiver (HCBS) program.
30M0150 Current Payment Sources Response 6 – Title programsTitle III – State Agency on Agency grantsTitle V – State programs for maternal and child healthTitle XX – State program for homemaking, chore service, home mgmt, or aide services
31M0150 Current Payment Sources Response 7 – Tri-Care programReplaced CHAMPUSResponse 10 – Patient is paying for all or part of the caree.g., copayments
32Items to be Used at Specific Time Points The following slides detail which items are required at each time point.
33Items to be Used at Specific Time Points (cont.) Start of CareStart of care—further visits plannedM0010-M0030, M0040- M0150, M1000-M1036, M1100-M1242, M1300-M1302, M1306, M1308-M1324, M1330-M1350, M1400, M1410, M1600-M1730, M1740-M1910, M2000, M2002, M2010, M2020-M2250Resumption of CareResumption of care (after inpatient stay)M0032, M0080-M0110, M1000-M1036, M1100-M1242, M1300-M1302, M1306, M1308-M1324, M1330-M1350, M1400, M1410, M1600-M1730, M1740-M1910, M2000, M2002, M2010, M2020-M2250Follow-UpRecertification (follow-up) assessmentOther follow-up assessmentM0080-M0100, M0110, M1020-M1030, M1200, M1242, M1306, M1308, M1322-M1324, M1330-M1350, M1400, M1610, M1620, M1630, M1810-M1860, M2030, M2200
34Items to be Used at Specific Time Points (cont.) Transfer to an Inpatient Facility Transferred to an inpatient facility patient not discharged from an agencyTransferred to an inpatient facility — patient discharged from agencyM0080-M0100, M1040-M1055, M1500, M1510, M2004, M2015, M2300-M2410, M2430-M2440, M0903, M0906Discharge from Agency --Not to an Inpatient FacilityDeath at homeDischarge from agencyM0080-M0100, M0903, M0906M0080-M0100, M1040-M1055, M1230, M1242, M1306-M1350, M1400-M1620, M1700-M1720, M1740, M1745, M1800-M1890, M2004, M2015-M2030, M2100-M2110, M2300-M2420, M0903, M0906