Educating Staff On Oasis E: If You Don't Educate ICD 10 Coders, It Is Like Only Utilizing One Side Of The Brain.

June 9, 2023

While working with agencies throughout the United States, we have the opportunity to see how many operate. This leads us to talk today about the new Oasis E tool being implemented  January 1st 2023. For those who have been in the industry for decades, the implementation of a changed tool is not unusual. In our experience, when agencies educate on Oasis changes, it is normally limited to clinical staff who complete the tool. We need to look at this from the standpoint of ICD 10 coders. It is imperative for your ICD 10 coders to know the assessment tool inside and out.

What Are The Changes From Oasis D to Oasis E?

CMS updated the Oasis E tool on May 16th, 2022 and provided a PDF to the changes from the February 1, 2022 version. The changes are in line with expansion of Home Health Value Based Purchasing (HHVBP). So, it aligns with outcome based reimbursement. Now more than ever, the Oasis must be marked properly. We see the implementation of 3 different assessments within the tool: Brief Interview for Mental Status (BIMS),Signs and Symptoms of Delirium from the Cognitive Assessment Method (CAM), and the Patient Mood Interview (PHQ 9) which allows for expanded screening for depression. McBee and Associates offers a nice visual crosswalk tool to illustrate the changes from the Oasis D to E.

What Does This Do For ICD 10 Coding?

It means your Oasis needs to paint the actual clinical picture. Your ICD 10 coding isn't accurate if the documentation doesn't align. This isn't new.  Now, HHVBP is going to need to see the outcomes on our patients come to fruition or your reimbursement will suffer. The check and balance of the certified coder means they need to understand the assessment tool as well or better than the nurse who does the assessment. The nurses look at the tool in a different way than the certified ICD 10/ Oasis coder. This is the analogy of the 2 sides of the brain. Putting both of these clinical pieces together is the whole picture and therefore, the whole brain completes the Oasis and coding puzzle. The coder is able to catch discrepancies or address items that don't fully align with the diagnoses based upon other documentation. You may currently have your agency doing coding in-house and if your coders are Oasis and ICD 10 certified, then great. Check their ongoing accuracy and whether it makes financial sense to keep it in-house. Spend the time and money to make sure your ICD 10 coders keep up-to-date on changes.  If you don't have certified coders in place, then outsource your coding and Oasis review or you may really be penalized for errors in the tool. If you are looking to outsource, then make sure the person doing the coding is certified in ICD 10 and Oasis. Agencies Can't afford to have Oasis or ICD 10 coding errors cost them money. If you are looking to check the accuracy of your current coding system, outsource your coding, or need someone to provide educational assistance on the new Oasis E tool, Kenyon Homecare Consulting can help. Call us today at 206-721-5091 or contact us online to see how we can help!


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