Home health agencies are getting a first look at the OASIS-C2 guidance manual that updates the data set scheduled to go into effect beginning Jan. 1, 2017, for all assessments.

CMS says in guidance released today that agencies may adopt in their clinical practice and documentation the National Pressure Ulcer Advisory Panel (NPUAP) wound staging guidelines revised earlier this year.

“However, since CMS has adapted the NPUAP guidelines for OASIS purposes, the definitions do not perfectly align with each stage as described by NPUAP,” the manual states. “When discrepancies exist between the NPUAP definitions and the OASIS scoring instructions provided in the OASIS Guidance Manual and CMS Q&As, providers should rely on the CMS OASIS instructions.”

It had been expected that CMS would adopt the recent wound staging guidance from the NPUAP that changed the terminology from “pressure ulcer” to “pressure injury” and added more specific language in its wound descriptions.

The OASIS data set was revised to increase standardization with assessment item sets for post-acute care (PAC) settings and establish quality measures under the Improving Medicare Post-Acute Care Transformation (IMPACT Act) of 2014. The updated version of the assessment manual has new items, modifies item wording, adds new numbering or changes response options to existing items.

On wounds, M1306 (Unhealed pressure ulcer at stage II or higher) and M1307 (Oldest non-epithelialized non-pressure ulcer) were changed from Roman to Arabic numerals.

The assessment has two new items, M1028 (Active diagnosis co-morbidities and co-existing conditions) and M1060 (Height and weight).

Item numbers were changed in five items: M1311 (Current number of unhealed pressure ulcers), M1313 (Worsening in pressure ulcer status since SOC/ROC), M1501 (Symptoms in heart failure patients), M1511 (Heart failure follow-up) and M2001 (Drug regimen review).

Wording to medication item M2001 added the new number and documented that medication reconciliation removed the option “not assessed/not reviewed” as a response, and “problems” was changed to “issues.”