OASIS-E Spotlight: BIMS Summary Score

July 31, 2023

Making sense of CMS guidelines is more challenging than ever after the launch of OASIS-E and the abundance of changes that go along with it. KanTime’s OASIS Spotlight series will spotlight specific OASIS items to simplify the ruling and help clinicians significantly improve their understanding of OASIS so they can move forward with accuracy.

C0500: BIMS Summary Score

This week we’ll finish with the items that make up the BIMS.

Per the OASIS Guidance Manual:

    • Utilizing the BIMS for evaluation of cognitive ability decreases the chance of incorrect assessment and improves the detection of delirium.
    • The BIMS total score is highly correlated with Mini-Mental State Exam (MMSE; Folstein, Folstein, & McHugh, 1975) scores.
    • Scores from a carefully conducted BIMS assessment where patients can hear all questions and the patient is not delirious suggest the following distributions:
      • 13-15: cognitively intact
      • 8-12: moderately impaired
      • 0-7: severe impairment

Time points:

    • Start of Care
    • Resumption of Care
    • Discharge from agency

Response-Specific Instructions

    • After completing C0200-C0400:
      • Add up the values for all questions from C0200 through C0400.

Coding Instructions

    • Enter the total score as a two-digit number. The total possible BIMS score ranges from 00 to 15.
    • If the patient chooses not to answer a specific question(s), that question is coded as incorrect and the item(s) counts in the total score.
    • If, however, the patient chooses not to answer four or more items, then the interview is coded as incomplete.
    • To be considered a completed interview, the patient had to attempt and provide relevant answers to at least four of the questions included in C0200-C0400C.
    • To be relevant, a response only has to be related to the question (logical); it does not have to be correct. See general coding tips that follow for patients who choose not to participate at all.
      • If all BIMS items (C0200-C0400) are coded with a “-“ (dash), code C0500 Summary Score with a “- “ (dash).
      • Code 99, unable to complete interview, if
        • (a) the patient chooses not to participate in the BIMS,
        • (b) if four or more items were coded 0 because the patient chose not to answer or gave a nonsensical response, or
        • (c) if any but not all of the BIMS items is coded with a “-” (dash).

Note: a zero score does not mean the BIMS was incomplete. To be incomplete, a patient had to choose not to answer or give completely unrelated, nonsensical responses to four or more items.

Stay tuned for next Monday’s spotlight so your practice can continue to stay ahead of the curve and provide elite patient care through the Oasis E changes.

We provide clinicians that are part of the Kantime enterprise system with links to the guidance from CMS for each individual OASIS item. If you would like to learn more about how better happens, contact us at sales@kanrad.com to schedule a demo.

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