A fall that occurs due to a medical event, such as a seizure, is considered a fall for the purposes of coding M1033 (Risk for Hospitalization), J1800 (Any fall since SOC/ROC) and J1900 (Number of falls since SOC/ROC), CMS clarified in the April 2024 quarterly OASIS Q&As — released April 16. 
 
This was in response to a question asking about a scenario where a patient has a seizure which causes them to fall and sustain a subdural hematoma. 
 
The question asks CMS if this should be considered a fall with major injury under the OASIS. 
 
The April Q&As include six questions covering additional topics such as: 
  • Clarification around how to properly score for GG0100A (Prior functioning: Everyday activities) 
  • Guidance around whether clinicians are required to accept auditor recommendations for OASIS items 
  • How the symptom control ratings are defined for column two for M1021/M1023 
  • Agency policy around when to report a potential (or actual) clinically significant medication issue for the drug regimen review for M2001 – M2005. 
For a full story, see upcoming issues of Home Health Line and Diagnosis Coding Pro for Home Health.  
  
Editor’s note: To view the full CMS April 2024 quarterly OASIS Q&As, visit https://tinyurl.com/et5u2vzh.