Home Health Coding Update for M1024

Final Rule Effective January 1.

CMS has published in the final rule effective January 1, 2013 that M1024 on the OASIS assessment will only be used for acute fracture codes.  Resolved conditions of a patient are not to be coded in the home health setting, so this is to ensure compliance with coding guidelines.

In addition, they proposed a revision to the HH PPS Grouper logic to score Diabetes, Skin 1 or Neuro 1 diagnosis codes that are submitted immediately following a v-code in the primary diagnosis field the same as they are currently scored when a v-code is reported in the primary diagnosis field and the supporting diagnosis code is reported in M1024.   CMS will allow you to continue to fill in M1024, but the field will no longer be used to award case mix points for an increase in reimbursement.

For example, in 2012 a patient that was admitted to home health for skilled nursing aftercare and dressing change following an amputation of the foot due to diabetic PVD would be coded as follows:
Home Health M1024 Code
The same patient in 2013 will be coded as follows:
Home Health 2013 m1024 Code

Note that the reimbursement will not be decreased because Diabetes follows the v-code.

For assistance with M1024 or to learn more about our remote coding services, contact us today!