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What you need to know about the updated MDS items sets for 2019

Jan 11, 2019
The Bottom Line

CMS posted a new DRAFT version of the 2019 MDS item sets (v1.17.0) last week. This version is scheduled to become effective October 1, 2019, giving facilities until then to update their software with the new MDS questions and answers. Downloadable files can be accessed here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html

HCPro’s post-acute regulatory specialist Stefanie Corbett, DHA, reports the following changes:

New assessment types added – Optional State Assessment (OSA) and Interim Payment Assessment (IPA)

Discontinued assessment types eliminated – 14-day, 30-day, 60-day, 90-day, and unscheduled assessments used for PPS, OMRAs, and swing bed clinical change assessments

Section A

  • Language clarification

  • New item added to identify OSA for state purposes only (A0300A)

  • Discontinued assessment types eliminated – 14-day, 30-day, 60-day, 90-day, and unscheduled assessments used for PPS (A0310B)

  • OMRA assessment type eliminated (A0310C)

  • Swing bed clinical change assessment type eliminated (A0310D)

  • New item identifying Part A Interrupted Stay (A0310G1)

  • Unit certification/licensure designation added (A0410)

Section D

  • Indication of resident self-harm item eliminated (D0350 and D0650)

(Section G was surprisingly not edited although it was rumored that it would be eliminated with the last round of updates to Section GG. More changes to this section are likely to come at a later time.)

Section GG

  • Updated instructional language

Section I

  • Updated instructional language

  • Language clarification

  • New ICD Code item added (I0020B)

Section J

  • Skip pattern change (J1800)

  • New item added to identify whether resident received major surgical procedure during the prior inpatient hospital stay that requires active care (J2100)

  • New items added to identify surgical procedures (J2310 – J5000)

Section K

  • Language clarification

Section O

  • New items added to identify Part A Therapies (O425A-O425C):

    • By discipline

    • Number of minutes by type (individual, concurrent and group)

    • Days of therapy

  • New item added to identify the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes since the start date of the resident's most recent Medicare Part A stay (O0430)

  • Resumption of therapy items eliminated (O450A-O450B)

Section V

  • Updated instructional language

  • Discontinued assessments eliminated from response options - 14-day, 30-day, 60-day, 90-day, and unscheduled assessments used for PPS (V0100B)

  • IPA added as a response option (V0100B)

Section X

  • Discontinued assessments eliminated from response options - 14-day, 30-day, 60-day, 90-day, and unscheduled assessments used for PPS (X0600B-X0600D)

  • End of Therapy - Resumption (EOT-R) date eliminated (X0900E)

Section Z

  • Language updates to eliminate the use of acronym “RUG”

  • Medicare Short Stay assessment type eliminated (Z0100)

  • Medicare Part A Non-Therapy Billing items removed (Z0150A and Z0150B)

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