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OASIS C2: How to Answer M1028 Peripheral Vascular Disease

Posted by Nathan Hope on Jan 17, 2017

Here are a few key points to remember when answering the home health care form OASIS C2 M1028 for Peripheral Vascular Disease for MyHomecareBiz:

  • The physician or physician designee must confirm that these diagnoses are active and associated with the patient’s home health episode of care.
  •  Active diagnosis are diagnoses that have a direct relationship to the patient’s current functional, cognitive, mood or behavior status; medication treatments; nurse monitoring; or risk of death at the time of assessment. If the patient has one of these diagnoses and it is determined that it is not appropriate as a primary diagnosis and is not a comorbid condition that will be addressed in the plan of care and isn’t felt to have the potential to affect the patient’s responsiveness to treatment, it would not be reported as an active diagnosis in this item.
  • Do not report resolved diagnoses in this item.
  •  An omission is a valid response to this item, but remember what the omission means. This means that there is not enough information available and/or the item could not be assessed. So if the information is available and it is determined that the patient does not have either of these diagnoses, it is more appropriate to leave the response boxes unchecked.

 

download-home-health-PVD-careplan

 

M1028 Response Instructions for Peripheral Vascular Disease (PVD)

  • Select Response 1 if the patient has an active diagnosis of Peripheral Vascular Disease (PVD) or Peripheral Arterial Disease (PAD), indicated by any of the following...

Diagnosis Codes that start with the first 3 characters of:

  • I70.2 – Atherosclerosis of native arteries of the extremities
  • I70.3 – Atherosclerosis of bypass graft(s) of the extremities
  • I70.4 – Atherosclerosis of autologous vein bypass graft(s) of the extremities
  • I70.5 – Atherosclerosis of nonautologous biological bypass graft(s) of the extremities
  • I70.6 – Atherosclerosis of nonbiological bypass graft(s) of the extremities
  • I70.7 – Atherosclerosis of other type of bypass graft(s) of the extremities
  • I70.91 – Generalized atherosclerosis
  • I70.92 – Chronic total occlusion of artery of the extremities

 

Diagnosis Codes that start with the first 3 characters of:

  • I73. – Other peripheral vascular diseases

 

Tips for completing M1028 Peripheral Vascular Disease (PVD)

-There must be specific documentation in the medical record by a physician (or nurse practitioner, physician asimg-peripheral-vascular.jpesistant, clinical nurse specialist, or other authorized staff if allowable under state licensure laws) of the disease or condition being an active diagnosis.

- The physician (nurse practitioner, physician assistant, clinical nurse specialist, authorized licensed staff if allo
wable under state licensure laws) may specifically indicate that a diagnosis is active. Specific documentation areas in the medical record may include, but are not limited to, progress notes, admission history and physical, transfer notes, and the hospital discharge summary.

- The physician (nurse practitioner, physician assistant, clinical nurse specialist or other authorized licensed staff if allowable under state licensure laws) for example, documents at the time of assessment that the patient has inadequately controlled diabetes and requires adjustment of the medication regimen. This would be sufficient documentation of an active diagnosis and would require no additional confirmation because the physician documented the diagnosis and also confirmed that the mediation regimen needed to be modified.

- For the purposes of the OASIS Data Set, Home Health Agencies should consider only the documented active diagnoses. A diagnosis should not be inferred by association with other conditions (e.g., “weight loss” should not be inferred to mean “malnutrition”).

Examples of Active Peripheral Vascular Disease (PVD) Diagnoses

  • Example: Mrs. I underwent a below the knee amputation due to gangrene associated with peripheral vascular disease. She requires dressing changes to the stump and monitoring for wound healing. In addition, peripheral pulse monitoring is ordered. The nurse practitioner’s progress note documents peripheral vascular disease and left below the knee amputation.
  • Response 1: Peripheral Vascular Disease (PVD) would be checked.
  • Rationale: This would be considered an active diagnosis because the nurse practitioner’s note documents the peripheral vascular disease diagnosis, with peripheral pulse monitoring and recent below the knee amputation, with dressing changes and wound status monitoring.


 

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