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Confusion Prevails Over M0102 and M0104

Homecare Insider, November 1, 2010

Over the last few weeks, many providers have expressed confusion over data elements M0102 and M0104 on the OASIS-C assessment. Let’s clarify each of these data elements.   

The first data element, M0102, reads “Date of Physician-Ordered Start of Care (Resumption of Care): If the physician indicated a specific start of care (resumption of care) date when the patient was referred for home health services, record the date specified.”
This data element specifies the date the homecare services are ordered to begin and should reflect the updated date if the originally ordered date is updated by the physician due to the patient’s condition or extended hospitalization. This data element should be marked “NA” if the initial homecare orders did NOT specify a start of care date. Therefore, you will not have a date in this data element for each patient, but only for patients where the physician has specifically ordered a start of care date. One example of when this might occur is when a patient is discharged from the hospital needing wound care the next day and the physician orders homecare to begin on that date. That date would be recorded in this data element.
The next data element, M0104, seems to be generating the most confusion for providers. It reads “Date of Referral: Indicate the date that the written or documented referral for initiation or resumption of care was received by the home health agency.”
The date to be placed in this data element is the most recent date that verbal, written, or electronic authorization was received by the agency to begin homecare services. If the start of care date is delayed due to the patient’s condition or physician’s request, then the date the agency received updated or revised referral information for services to begin would be considered the date of referral. This data element does not refer to calls or documentation from others such as family or hospital staff who contact the agency to plan for possible admission.
Here’s one example of how to appropriately complete this data element. A patient is initially referred to the agency on September 1 pending discharge from the hospital. During the hospital stay, the patient acquires a pressure ulcer. The physician discharges the patient from the hospital on September 6, after calling the agency with an update in condition and new wound care instructions, including an order for more frequent visits than initially ordered. The date that would be placed in this data element is September 6 because that is the date when the agency received updated/revised referral information.
Are other data elements causing your agency confusion? Give staff more guidance with Beacon Health’s OASIS-C in Action video program and Home Health Pocket Guide to OASIS-C: A Reference for Field Staff, Revised Edition.