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OASIS-C1

On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015.  While the OASIS-C1 data item set had been approved by OMB on February 6, 2014 and scheduled for implementation on October 1, 2014, this version included five (5) of the data items which required the use ICD-10 codes.  Since ICD-10 has been delayed until at least October 1, 2015, we have made interim changes to the OASIS-C1 data item set.

The following is a summary of the changes that CMS has made in response to the legislatively mandated ICD-10 delay:

  1. OASIS-C1 Implementation
  1. The use of the OASIS-C data set was extended to December 31, 2014.

   OASIS-C1 / ICD-9 version:

  1. A modified version of OASIS-C1 (referred to as “OASIS-C1/ ICD-9 Version.”) was created. It  replaced the five OASIS-C1 items that use ICD-10 codes (i.e. - M1011, M1017, M1021, M1023, M1025) with the corresponding ICD-9-CM based items from OASIS-C (i.e. – M1010, M1016, M1020, M1022, M1024). The OASIS-C1/ ICD-9 Version underwent an “emergency” Paperwork Reduction Act review by OMB and was granted approval on October 10, 2014 for implementation on January 1, 2015.
  2. The OASIS-C1 / ICD-9 version will remain in effect until ICD-10 is implemented or until another disposition is made by CMS.  A copy of the full OASIS-C1/ ICD-9 data set, showing all data items, as well as the subsets of OASIS items that are to be collected at each time point (Start of care, recertification, etc.) are posted on the “OASIS Data Set” web page (see the link in the “Related Links” section below).

   OASIS-C1 / ICD-10 version:

  1. The OASIS-C1 / ICD-10 version of the OASIS data set will replace the five ICD-9-CM-based items in the OASIS-C1 / ICD-9 data set (M1010, M1016, M1020, M1022, M1024) with the corresponding ICD-10 items (M1011, M1017, M1021, M1023, M1025).
  2. The draft OASIS-C1 / ICD-10 version of the OASIS data set is currently under Paperwork Reduction Act review at OMB.
  3. A table showing the differences between the OASIS-C1 / ICD-9 and the draft OASIS-C1 / ICD-10 is shown below in the Downloads section.
  1. Payment Grouper Updates

The most current information about updates to the payment grouper software can be found on the Home Health PPS Case-Mix Grouper Software page via the link in the “Related Links” section below.