Confusion with M2250
Posted on February 19, 2010 in Coding Education
by Ann Giles, RN, BSN, HCS-D, COS-C
One of the new OASIS-C items that is frequently answered incorrectly is M2250. One of the most helpful tips I have heard is to start on the right and work your way to the left when answering each of the line items in this question. The common mistake is to answer "no" when the appropriate response is "na." Let's take a couple of line items to use as examples:
Let's first look at line "b." If you start on the right, you will see the first option is that the "patient is not diabetic or is bilateral amputee." The next column over is response "yes," indicating that the patient is diabetic and the physician-ordered plan of care does include interventions for diabetic foot care and monitoring for skin lesions. And the last option would be "no," indicating that the patient is diabetic and the physician ordered plan of care does not include diabetic foot care. The common mistake is to start on the left. Clinicians see response "no" and select it for non-diabetic patients, knowing that the plan of care does not include the above mentioned interventions, when the more appropriate response is "na." Misunderstanding the responses in the item can affect process measure data.
Let's take a look at line item "f." A common mistake is to answer "no" for patients that are not at risk for developing pressure ulcers. If you start on the right, the chances of answering incorrectly are minimized. You will find that the first response on the left is that the patient is not assessed to be at risk for pressure ulcers. This is a much more appropriate response if a screening was completed and no risk was found. You then move on to "yes" and "no," indicating that the physician-ordered plan of care includes or does not include prevention interventions.
Again, misunderstanding the responses in the item can affect process measure data. I cannot emphasize enough the importance of referring to the OASIS manual and OASIS Q&A's for guidance on these OASIS items.
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