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QIES Team

Diane Henry, Director MDS/OASIS  ♦  Bob Bischoff, Program Manager  ♦  Wanda Roberts, RN Consultant  


QIES OASIS Resources OASIS Regulation Forms and Manuals Privacy Notices Software

WHAT'S NEW - OASIS

Home Health PPS Software Package

Don’t’ forget to verify your software is up-to-date.

The Home Health Prospective Payment System (HH PPS) Grouper v6217 is available for download.  The HH PPS Grouper v6217 is a required update for OASIS submissions with an assessment completion date on or after October 1, 2017.

Some of the changes included within v6217:

  • New ICD-10 diagnosis codes effective for October 1, 2017 are added to the Home Health grouper with Diagnostic Groups and NRS Groups assigned to applicable codes.
  • ICD-10 diagnosis codes that are deleted effective October 1, 2017 are removed from the Home Health grouper.
  • ICD-10 diagnosis codes with revised code descriptions effective October 1, 2017 are updated.
  • Updated Diagnostic Group assignment for ICD-10 diagnosis code C70.0.
  • Removed the Diagnostic Group assignment for ICD-10 diagnosis codes L97.501 – L97.509, L97.801 – L97.809 due to an unspecified site of a chronic ulcer.

Home Health Claims Will Be Returned When No OASIS Is Found

Be sure you are submitting ALL required OASIS assessments timely.

Until matching errors are corrected, Medicare systems will Return to Provider (RTP) home health claims when no Outcome and Assessment Information Set (OASIS) is found. When these claims are returned with reason code 37253, use the F9 function to resubmit your claim after taking one of these actions:

  • Update the Health Insurance Claim (HIC) number on the OASIS assessment to match the current information
  • Correct the assessment completion date reported in the claim treatment authorization code to match the OASIS assessment
  • Resubmit for denial using condition code 21 and Type of Bill 320 if the assessment was not submitted

If you have questions please contact the QIES Help Desk at 405-271-5278.


View the Press Release on Fall Prevention Resources - Link to the Fall Prevention Resources web page


UPDATE: The 2018 OASIS-C2 Guidance manual is now available on the CMS website. Click the link to access the manual in the downloads section of the OASIS User Manuals web page.

This version of the manual should be used for all OASIS assessments completed on or after January 1, 2018.

For questions, please contact the QIES Help Desk at (405) 271-5278.


Security Update: Disabling and Deleting Accounts:

To better secure applications, QIES security requires each user to successfully login every 60 days, effective June 26, 2017. If this does not occur, the account will be disabled and can only be re-enabled by contacting the QTSO Help Desk at (800)339-9313.

Accounts that have no activity for more than 365 days will be deleted. Once your account is deleted, you will not be able to use or re-enable the account. If your account is deleted, you will need to request access through CMS as you did originally; you will be assigned a new User ID and password when the access is granted.

QIES users will continue to use QUMA to update passwords as required every 60 days; and use security questions to unlock accounts if the password is forgotten or the account is locked due to the password being entered incorrectly three times. 

Please forward this information to all staff who access CASPER Reports or submit MDS or OASIS assessments. 

If you have any questions concerning this information, please contact us at (405) 271-5278 or QTSO Help Desk at help@qtso.com or (800) 339-9313.


Notice:

Effective April 1, 2017, MACs will now deny claims when the condition of payment for submitting patient assessment data has not been met. Make sure that your billing staff is aware of this change. OASIS reporting regulations require the OASIS to be transmitted within 30 days of completing the assessment of the beneficiary. If the OASIS assessment is not found in the QIES upon receipt of a final claim for a HH episode, and the receipt date of the claim is more than 30 days after the assessment completion date, Medicare systems will deny the HH claim. (While the regulation requires the assessment to be submitted within 30 days, the initial implementation of this edit will allow 40 days.)

Home Health QRP: OASIS-C2 Approved by OMB - CMS received approval on Friday, December 9, 2016 for the OASIS-C2 form. Effective January 1, 2017, HHA Providers and Vendors shall begin using the OASIS-C2 in submitting assessments. As a reminder, the guidance manual for OASIS-C2 is available at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIOASISUserManual.html. 

Please direct any questions about using the OASIS-C2 to the QIES Help Desk at (405) 271-5278.


QIES OASIS RESOURCES 

  • Home Health Quality Initiative web page includes links to:
    • Home Health Compare
    • Wound Ostomy Continence Nurses Society
    • National Pressure Ulcer Advisory Panel
    • Agency for Healthcare Research and Quality 
  • OASIS Spotlight web page includes the latest OASIS news, updates and helpful information.

CMS has created four training videos related to OASIS-C and process measure items. They are available on YouTube as follows:

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OASIS REGULATION 

Code of Federal Regulations:

       42 CFR 484.20 
       42 CFR 484.55

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FORMS AND MANUALS

  • HHA Correction Policy - Located on the QTSO's OASIS Download web page towards the bottom of OASIS Downloads/Documentation section.

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PRIVACY NOTICES

For Medicare and Medicaid Patients:

For Non-Medicare and Non-Medicaid Patients:

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SOFTWARE

Home Health Agencies have two options available for obtaining software specific to the transmission of OASIS assessment data:

  • 1. Agencies may obtain software developed by private vendors, but need to ensure the software meets the minimum specifications established by CMS.
  • - OR -
  • 2. Agencies may obtain jHAVEN software, developed and maintained by CMS, free of charge. -HAVEN Software and HelpDesk information may be found on the CMS/QTSO web page links below:

jHAVEN Software for Home Health Providers:

Dialer Software (Juniper Client/Verizon):

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Special Announcements

For more information on MDS Training and Workshops, click here.

For more information on OASIS Training and Workshops, click here.


What's New - Nursing Homes



What's New - Home Health




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