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.
J0520 Pain Interference with Therapy Activities
The changes in OASIS-E for evaluating a patient’s pain and its impact on their day-to -day activities is captured in a series of 3 items called the Pain Interview.
For this installment of the OASIS-E Spotlight we’ll look at the second item, J0520 Pain Interference with Therapy Activities.
Per the OASIS-E Guidance Manual, Rehabilitation Therapy is defined as:
“Special healthcare service or programs that help a person regain physical, mental, and/or cognitive (thinking and learning) abilities that have been lost or impaired as a result of disease, injury, or treatment. Can include, for example, physical therapy, occupational therapy, speech therapy, and cardiac and pulmonary therapies.”
- Start of Care
- Resumption of Care
- Discharge from Agency
Ask patient: “Over the past 5 days, how often have you limited your participation in rehabilitation therapy sessions due to pain?”
Code 0, Does not apply, if the patient responds that they did not participate in rehabilitation therapy
for reasons unrelated to pain (e.g., therapy not needed, unable to schedule) in the past 5 days.
Code 1, Rarely or not at all, if the patient responds that pain has rarely or not at all limited participation in rehabilitation therapy sessions in the past 5 days.
Code 2, Occasionally, if the patient responds that pain has occasionally limited participation in rehabilitation therapy sessions in the past 5 days.
Code 3, Frequently, if the patient responds that pain has frequently limited participation in rehabilitation therapy sessions in the past 5 days.
Code 4, Almost constantly, if the patient responds that pain has almost constantly limited participation in rehabilitation therapy sessions in the past 5 days.
Code 8, Unable to answer, if the patient is unable to answer the question, does not respond or gives a nonsensical response.
Dash is NOT a valid response for this item.
Additional CMS guidance includes the following:
- Read the question and response choices as written.
- No predetermined definitions are offered to the patient. The response should be based on the patient’s interpretation of frequency response options.
- Confirm that the patient has been offered rehabilitation therapies during the reference time frame.
- This item should be coded based on the patient’s interpretation of the provided response options for frequency. If the patient is unable to decide between 2 options, then the assessing clinician should code for the option with the higher frequency.
- Rehabilitation therapies may include treatment supervised in person by a therapist or nurse or other staff, or the patient/family/caregivers carrying out a prescribed therapy program without agency staff present.
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.
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