M0100_ASSMT_REASON


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Property Specification
Data System OASIS
Data Specs V2.31.0
Description Reason for assessment
Group Asmt
Type Code
Length 2
Fixed Start-End 443-444
Version Notes

Item Subsets
Active 01,03,04,05,06,07,08,09,XX
Inactive

Item Values
Value LOINC Text
01 Start of care - further visits planned
03 Resumption of care (after inpatient stay)
04 Recertification (follow-up) reassessment
05 Other follow-up
06 Transferred to an inpatient facility - patient not discharged from agency
07 Transferred to an inpatient facility - patient discharged from agency
08 Death at home
09 Discharge from agency

Item Edits
Edit ID Type Severity Edit Text
-3060 Format Fatal VALUES OF CODE AND CHECKLIST ITEMS
Only the coded values listed in the "Item Values" table of the Detailed Data Specifications Report may be submitted for this item.
-3190 Consistency Fatal In order to modify or inactivate a record that has previously been accepted by the system, the system must be able to locate the previous record. Appropriate values from the record to be corrected must therefore be submitted for the following locator items:

M0030_START_CARE_DT
M0032_ROC_DT
M0032_ROC_DT_NA
M0040_PAT_FNAME
M0040_PAT_LNAME
M0064_SSN
M0064_SSN_UK
M0066_PAT_BIRTH_DT
M0069_PAT_GENDER
M0090_INFO_COMPLETED_DT
M0100_ASSMT_REASON
M0906_DC_TRAN_DTH_DT

If a matching previously accepted record cannot be located, a fatal error will result and the submitted record will be rejected.
-3280 Consistency Warning If M0100_ASSMT_REASON=[01] and if M0030_START_CARE_DT and M1005_INP_DISCHARGE_DT are both active and contain valid dates (not [^]), then M0030_START_CARE_DT minus M1005_INP_DISCHARGE_DT should be greater than or equal to zero and less than or equal to 14 days.
-3290 Consistency Warning If M0100_ASSMT_REASON=[03] and if M0032_ROC_DT and M1005_INP_DISCHARGE_DT are both active and contain valid dates (not [^]), then M0032_ROC_DT minus M1005_INP_DISCHARGE_DT should be greater than or equal to zero and less than or equal to 14.
-3300 Consistency Warning If M0100_ASSMT_REASON=[01] and if M0090_INFO_COMPLETED_DT and M0030_START_CARE_DT are both active and contain valid dates (not [^]), then M0090_INFO_COMPLETED_DT minus M0030_START_CARE_DT should be greater than or equal to zero and less than or equal to 5.
-3310 Consistency Warning If M0100_ASSMT_REASON=[03] and if M0090_INFO_COMPLETED_DT and M0032_ROC_DT are both active and contain valid dates (not [^]), then M0090_INFO_COMPLETED_DT minus M0032_ROC_DT should be greater than or equal to zero and less than or equal to 2.
-3320 Consistency Warning If M0100_ASSMT_REASON=[09] and if M0090_INFO_COMPLETED_DT and M0906_DC_TRAN_DTH_DT are both active and contain valid dates (not [^]), then M0090_INFO_COMPLETED_DT minus M0906_DC_TRAN_DTH_DT should be greater than or equal to zero and less than or equal to 2.
-4320 Consistency Fatal If M0100_ASSMT_REASON=[09], then if M1600_UTI is active it cannot equal [UK].
-4350 Consistency Fatal ***THIS EDIT WAS DELETED IN V2.31.0***
-4351 Consistency Fatal If M0100_ASSMT_REASON=[09], then if M1620_BWL_INCONT is active it cannot equal [UK].
-4480 Consistency Fatal If M0100_ASSMT_REASON=[09] then M2020_CRNT_MGMT_ORAL_MDCTN cannot equal [^].
-4490 Consistency Fatal ***THIS EDIT WAS DELETED IN V2.31.0***
-4570 Consistency Fatal If M0100_ASSMT_REASON=[09], then if M2410_INPAT_FACILITY is active it must equal [NA].
-4580 Consistency Fatal If M0100_ASSMT_REASON=[06,07], then if M2410_INPAT_FACILITY is active it must not equal [NA].
-4730 Consistency Fatal If M0100_ASSMT_REASON=[01], then M0032_ROC_DT_NA must be [1].
-4740 Consistency Fatal If M0100_ASSMT_REASON=[03], then M0032_ROC_DT_NA must be [0].
-4820 Consistency Warning ***THIS EDIT WAS DELETED IN V2.31.0***
-5290 Consistency Fatal If M0100_ASSMT_REASON=[06,07,08,09], then M0906_DC_TRAN_DTH_DT must not equal [^].
-5300 Consistency Fatal If TRANS_TYPE_CD=[3] (inactivate existing record) and M0100_ASSMT_REASON=[01,03,04,05], then M0906_DC_TRAN_DTH_DT must equal [^].
-5340 Consistency Fatal If M0104_PHYSN_RFRL_DT is not equal to [^] and if M0100_ASSMT_REASON=[01], then M0104_PHYSN_RFRL_DT must be less than or equal to M0030_START_CARE_DT and must be greater than M0066_PAT_BIRTH_DT.
-5350 Consistency Fatal If M0104_PHYSN_RFRL_DT is not equal to [^] and if M0100_ASSMT_REASON=[03], then M0104_PHYSN_RFRL_DT must be less than or equal to M0032_ROC_DT and must be greater than M0066_PAT_BIRTH_DT.
-5660 Consistency Fatal ***THIS EDIT WAS DELETED IN V2.31.0***
-5661 Consistency Fatal If M0100_ASSMT_REASON = [01,03], then none of the following items can be equal to [-]: M1311_NBR_PRSULC_STG2_A1, M1311_NBR_PRSULC_STG3_B1, M1311_NBR_PRSULC_STG4_C1, M1311_NSTG_DRSG_D1, M1311_NSTG_CVRG_E1, and M1311_NSTG_DEEP_TSUE_F1.
-5680 Consistency Fatal ***THIS EDIT DELETED IN V2.31.0***
-5681 Consistency Fatal a) If M0100_ASSMT_REASON = [01,03], and M1322_NBR_PRSULC_STG1 and M1311_NBR_PRSULC_STG2_A1 and M1311_NBR_PRSULC_STG3_B1 and M1311_NBR_PRSULC_STG4_C1 are all equal to [00,^], then if M1324_STG_PRBLM_ULCER is active it must be equal to [NA].
b) If M0100_ASSMT_REASON=[09], and if M1311_NBR_PRSULC_STG2_A1, M1311_NBR_PRSULC_STG3_B1 and M1311_NBR_PRSULC_STG4_C1 are all equal to [00,-,^], then M1324_STG_PRBLM_ULCER must be equal to [1, NA].

Supplemental Information
Edit ID Type Severity Edit Text
-9060 Information None CALCULATION OF EFFECTIVE DATE
a) If M0100_ASSMT_REASON=[01], then ASMT_EFF_DATE is equal to M0030_START_CARE_DT.

b) If M0100_ASSMT_REASON=[03], then ASMT_EFF_DATE is equal to M0032_ROC_DT.

c) If M0100_ASSMT_REASON=[04,05], then ASMT_EFF_DATE is equal to M0090_INFO_COMPLETED_DT.

d) If M0100_ASSMT_REASON=[06,07,08,09], then ASMT_EFF_DATE is equal to M0906_DC_TRAN_DTH_DT.
-9080 Information None COMPLETION OF FOLLOW-UP ASSESSMENTS
The allowable completion dates for the first and any subsequent follow-up assessments will be calculated relative to the start of care date. Follow-up assessments must be completed every 60 days that a patient is under care. Each time a follow-up assessment is due, it should be completed on or after the 56th day and on or before the 60th day of the period.

More formally, the rules can be stated as follows:

-Let j be the follow-up period number (i.e., 1=first follow-up period, 2=second follow-up period, etc.).

-Let SOC be the start of care date (M0030_START_CARE_DT).

-Let FCD be the completion date (M0090_INFO_COMPLETED_DT) of a follow-up assessment.

Given these symbols, the rule for completion of follow-up assessments is as follows:

SOC + (60*j) - 5 <= FCD <= SOC + (60*j) - 1

Where j=1, 2, 3, etc.

If a patient is under care by a home health agency during one of the follow-up windows defined above, a follow-up assessment must be submitted. An exception to this rule can occur if a patient resumes care following an inpatient stay and if the resumption of care date (M0032_ROC_DT) falls within one of the follow-up windows. In this case, the home health agency should submit an RFA 03 resumption of care (after inpatient stay) (M0100_ASSMT_REASON=[03]) instead of the normal follow-up assessment. Submission of such a resumption of care assessment fulfills the requirement for the follow-up assessment because it includes all of the data items contained in the normal follow-up assessment.
-9160 Information None The Item Subset Code (ISC) is a two-character code that indicates the type of record that is being submitted. The set of active items is controlled by the ISC. The ISC is defined as follows:

If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [01]
then ITM_SBST_CD = [01]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [03]
then ITM_SBST_CD = [03]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [04]
then ITM_SBST_CD = [04]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [05]
then ITM_SBST_CD = [05]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [06]
then ITM_SBST_CD = [06]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [07]
then ITM_SBST_CD = [07]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [08]
then ITM_SBST_CD = [08]
If TRANS_TYPE_CD = [1,2] and M0100_ASSMT_REASON = [09]
then ITM_SBST_CD = [09]
If TRANS_TYPE_CD = [3] and M0100_ASSMT_REASON = [01-09]
then ITM_SBST_CD = [XX]

For a more complete explanation of the meaning and use of the ISC codes, please refer to the documentation that accompanies these data specifications.

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Generated: 10/17/2019 10:42:18 PM