Three Tips for Answering M1012
Posted on January 28, 2010 in Coding Education
by Ann Giles, RN, BSN, HCS-D, COS-C
Since the implementation of OASIS-C, there has been a widespread misunderstanding of M1012 (inpatient diagnoses). According to the OASIS manual, M1012 "identifies medical procedures that the patient received during an inpatient facility stay within the past 14 days that are relevant to the home health plan of care." There are three important points to remember when answering this question.
- CMS is looking for procedure codes, not ICD-9 codes. Procedure codes are four digit codes and are found in the very back of the Decision Health Coding Manual.
- It is important to recognize the time period that CMS is referring to. If a patient has been discharged from an inpatient facility during the past 14 days, all procedures related to that inpatient stay should be taken into consideration when answering this OASIS item, even if the procedure occurred earlier than the 14 days prior to home care.
- Guidance indicates that the procedure in question needs to relate to the home health plan of care.
Consider this scenario: A patient was hospitalized for a joint replacement and also during this admission had a CT of the head for chronic sinus problems. You are now admitting him to home health for physical therapy. The CT scan of the sinuses has no impact on your home health plan of care and should not be coded in M1012. The joint replacement, however, is the main reason for the home care admission and should be reported in M1012.
As with many of the OASIS items, there is more to this question than the words on the OASIS. By remembering these three simple points when answering M1012, assigning inpatient procedure codes will be easier.
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