OASIS - (Attachment D: Selection & Assignment of OASIS Diagnosis) Guidance

The bulleted information below includes guidance for the OASIS Implementation Manual: Chapter 8 - "Attachment D: Selection and Assignment of OASIS Diagnosis."   "Attachment D" is available in the Downloads section below.

• Notification of errors in Attachment D to Chapter 8 of the "OASIS Implementation Manual"
  First bullet in Section D (3) (b) of Attachment D contains an error. Currently, the first bullet in this section of the document incorrectly omits specific secondary diagnosis instruction. The correct wording is the following: “Ensure that the secondary diagnosis under consideration includes not only conditions actively addressed in the patient's plan of care but also any comorbidity affecting the patient's responsiveness to treatment and rehabilitative prognosis, even if the condition is not the focus of any home health treatment itself.” (Posted 02/12/09)
• First sentence in Section D (3) of Attachment D contains an error. Currently, the first sentence in this section of the document omits the word “or” before the phrase “affect the treatment or care”. The correct wording is the following: “Secondary diagnoses, or other diagnoses, are defined as all conditions that coexisted with the primary diagnosis at the time the plan of care was established, or which developed subsequently, or affect the treatment or care of the patient”. (Posted 02/12/09)
• Section D (4) (c) (3) of Attachment D contains an error. Currently, this section of the document incorrectly lists the Neuro 3-Stroke diagnosis group. The correct diagnosis group is Neuro 1-Brain Disorders and Paralysis. Case Scenario #4 also incorrectly assigns a diagnosis from the Neuro 3-Stroke diagnosis group. The correct diagnosis assignment in Scenario #4 should be from the Neuro 1- Brain Disorders and Paralysis diagnosis group. Revisions to the above section of Attachment D, to include revisions to the associated Case Scenario #4, will be posted in the near future. Questions related to Attachment D should be sent to: AskOasisAttachD@cms.hhs.gov.   (Posted 01/23/09)
• “Attachment D” to Chapter 8 of the “OASIS Implementation Manual” has been reissued to promote accurate selection and assignment of the patient's diagnosis on the current OASIS (OASIS B1 (1/2008)).  This document clarifies CMS expectations specific to the assignment of diagnosis codes to the OASIS as dictated by the revised ICD-9-CM coding guidelines effective Oct. 2008 and the HH PPS refinements effective January, 2008.  Attachment D addresses the diagnoses items that pertain to the home health episode (i.e., M0230, M0240 and M0246). (posted 12/31/2008)