Come Jan. 1, any fall or intercepted fall that results in a major injury — regardless of how or when the fall occurred — should be reported as both a fall and a major injury when responding to J1800 (Any Falls Since SOC/ROC) and J1900 (Number of Falls Since SOC/ROC), CMS clarified in the final quarterly OASIS Q&As of the year, released Nov. 20.  
 
This was in response to a question highlighting a patient who loses their balance while participating in a balance retraining activity with a therapist and has a fall resulting in a hip fracture.  
 
The question then goes on to ask whether this should be reported as a fall under J1800 since it occurred while the patient was participating in a supervised therapeutic intervention where the patient’s balance was intentionally challenged. 
 
To this, CMS advised that it should be coded as a fall under J1800 and major injury under J1900. 
 
“Effective Jan. 1, 2026, whenever a major injury results from a fall or intercepted fall, regardless of why or when the fall occurs, it would be reported as both a fall and a major injury in J1800 and J1900,” CMS responded. 
 
This was one of 11 questions included in the most recent update — several of which revolve around the updated guidance coming for reporting falls. 
 
 Additional topics covered in the most recent release include:     
  • If OASIS data needs to be collected and submitted for Medicare Part B outpatient therapy service patients who are being seen by a home health agency. 
  • Whether or not “antineoplastic” medication being given as a cancer treatment should be captured under O0110A1 (Chemotherapy)? 
  • How GG0100 (Prior Level of Functioning: Everyday Activities) should be coded for a patient who received supervision/cueing assistance via in-home camera monitoring from a helper. 
For a full story, see the upcoming issues of Home Health Line and Diagnosis Coding Pro for Home Health.     
 
Editor’s note: To view the most recent 2025 quarterly OASIS Q&As in full, visit https://tinyurl.com/mt44xuup.