M-Items in Home Health Coding : Home Health Patient Tracking Sheet

If you are a home health coder, You already know about M-items in home health coding or patient tracking sheet. In this article we are going to discuss not all but important M-Items used in home health coding by any home health coder.

Before discussing about M-items , we will know about OASIS.

O – Out Patient

AS – Assessment

I – Information

S – Set

The Outcome and Assessment Information Set (OASIS) is the patient-specific, standardized assessment used in Medicare home health care to plan care, determine reimbursement, and measure quality.

Important M – ITEMS in Home Health Coding :

M0110

1 Early
2 Later
UK Unknown
NA Not Applicable: No Medicare case mix group to be defined by this assessment.

M1000

1 – Long-term nursing facility (NF)
2 – Skilled nursing facility (SNF/TCU)
3 – Short-stay acute hospital (IPPS)
4 – Long-term care hospital (LTCH)
5 – Inpatient rehabilitation hospital or unit (IRF)
6 – Psychiatric hospital or unit
7 – Other (specify)
NA – Patient was not discharged from an inpatient facility [Go to M1021]

M1028

Active Diagnoses – Comorbidities and Co-existing Conditions – Check all that apply
See OASIS Guidance Manual for a complete list of relevant ICD-10 codes.

1 – Peripheral Vascular Disease (PVD) or Peripheral Arterial Disease (PAD)
2 – Diabetes Mellitus (DM)
3 – None of the above

M1030

Therapies the patient receives at home: (Mark all that apply.)

1 – Intravenous or infusion therapy (excludes TPN)
2 – Parenteral nutrition (TPN or lipids)
3 – Enteral nutrition (nasogastric, gastrostomy, jejunostomy, or any other artificial entry into the
alimentary canal)
4 – None of the above

M1033

Risk for Hospitalization: Which of the following signs or symptoms characterize this patient as at risk for
hospitalization? (Mark all that apply.)

1 – History of falls (2 or more falls – or any fall with an injury – in the past 12 months)
2 – Unintentional weight loss of a total of 10 pounds or more in the past 12 months
3 – Multiple hospitalizations (2 or more) in the past 6 months
4 – Multiple emergency department visits (2 or more) in the past 6 months
5 – Decline in mental, emotional, or behavioral status in the past 3 months
6 – Reported or observed history of difficulty complying with any medical instructions (for example,
medications, diet, exercise) in the past 3 months
7 – Currently taking 5 or more medications
8 – Currently reports exhaustion
9 – Other risk(s) not listed in 1 – 8
10 – None of the above

M1200

Vision (with corrective lenses if the patient usually wears them):

0 Normal vision: sees adequately in most situations; can see medication labels, newsprint.
1 Partially impaired: cannot see medication labels or newsprint, but can see obstacles in path,
and the surrounding layout; can count fingers at arm’s length.
2 Severely impaired: cannot locate objects without hearing or touching them, or patient
nonresponsive.

M1242

Frequency of Pain Interfering with patient’s activity or movement:

0 Patient has no pain
1 Patient has pain that does not interfere with activity or movement
2 Less often than daily
3 Daily, but not constantly
4 All of the time

M1340

Does this patient have a Surgical Wound?

0 No [Go to M1400]
1 Yes, patient has at least one observable surgical wound
2 Surgical wound known but not observable due to non-removable dressing/device [Go to M1400]

M1342

Status of Most Problematic Surgical Wound that is Observable

0 Newly epithelialized
1 Fully granulating
2 Early/partial granulation
3 Not healing

M1400

When is the patient dyspneic or noticeably Short of Breath?

0 Patient is not short of breath
1 When walking more than 20 feet, climbing stairs
2 With moderate exertion (for example, while dressing, using commode or bedpan, walking
distances less than 20 feet)
3 With minimal exertion (for example, while eating, talking, or performing other ADLs) or with
agitation
4 At rest (during day or night)

M1600

Has this patient been treated for a Urinary Tract Infection in the past 14 days?

0 No
1 Yes
NA Patient on prophylactic treatment
UK Unknown [Omit “UK” option on DC]

M1610

Urinary Incontinence or Urinary Catheter Presence:

0 No incontinence or catheter (includes anuria or ostomy for urinary drainage)
1 Patient is incontinent
2 Patient requires a urinary catheter (specifically: external, indwelling, intermittent, or
suprapubic)

M1620

Bowel Incontinence Frequency:

0 Very rarely or never has bowel incontinence
1 Less than once weekly
2 One to three times weekly
3 Four to six times weekly
4 On a daily basis
5 More often than once daily
NA Patient has ostomy for bowel elimination
UK Unknown [Omit “UK” option on FU, DC]

M1630

Ostomy for Bowel Elimination: Does this patient have an ostomy for bowel elimination that (within
the last 14 days): a) was related to an inpatient facility stay; or b) necessitated a change in medical
or treatment regimen?

0 Patient does not have an ostomy for bowel elimination.
1 Patient’s ostomy was not related to an inpatient stay and did not necessitate change in medical
or treatment regimen.
2 The ostomy was related to an inpatient stay or did necessitate change in medical or treatment
regimen.

M1700

Cognitive Functioning: Patient’s current (day of assessment) level of alertness, orientation,
comprehension, concentration, and immediate memory for simple commands.

0 Alert/oriented, able to focus and shift attention, comprehends and recalls task directions
independently.
1 Requires prompting (cuing, repetition, reminders) only under stressful or unfamiliar
conditions.
2 Requires assistance and some direction in specific situations (for example, on all tasks
involving shifting of attention) or consistently requires low stimulus environment due to
distractibility.
3 Requires considerable assistance in routine situations. Is not alert and oriented or is unable
to shift attention and recall directions more than half the time.
4 Totally dependent due to disturbances such as constant disorientation, coma, persistent
vegetative state, or delirium.

M1710

When Confused (Reported or Observed Within the Last 14 Days):

0 Never
1 In new or complex situations only
2 On awakening or at night only
3 During the day and evening, but not constantly
4 Constantly
NA Patient nonresponsive

M1720

When Anxious (Reported or Observed Within the Last 14 Days):

0 None of the time
1 Less often than daily
2 Daily, but not constantly
3 All of the time
NA Patient nonresponsive

M1740

Cognitive, behavioral, and psychiatric symptoms that are demonstrated at least once a week
(Reported or Observed): (Mark all that apply.)

1 – Memory deficit: failure to recognize familiar persons/places, inability to recall events of past 24
hours, significant memory loss so that supervision is required
2 – Impaired decision-making: failure to perform usual ADLs or IADLs, inability to appropriately stop
activities, jeopardizes safety through actions
3 – Verbal disruption: yelling, threatening, excessive profanity, sexual references, etc.
4 – Physical aggression: aggressive or combative to self and others (for example, hits self, throws
objects, punches, dangerous maneuvers with wheelchair or other objects)
5 – Disruptive, infantile, or socially inappropriate behavior (excludes verbal actions)
6 – Delusional, hallucinatory, or paranoid behavior
7 – None of the above behaviors demonstrated

M1745

Frequency of Disruptive Behavior Symptoms (Reported or Observed): Any physical, verbal, or
other disruptive/dangerous symptoms that are injurious to self or others or jeopardize personal
safety.

0 Never
1 Less than once a month
2 Once a month
3 Several times each month
4 Several times a week
5 At least daily

M1800

Grooming: Current ability to tend safely to personal hygiene needs (specifically: washing face and
hands, hair care, shaving or make up, teeth or denture care, or fingernail care).

0 Able to groom self unaided, with or without the use of assistive devices or adapted methods.
1 Grooming utensils must be placed within reach before able to complete grooming activities.
2 Someone must assist the patient to groom self.
3 Patient depends entirely upon someone else for grooming needs

M1810

Current Ability to Dress Upper Body safely (with or without dressing aids) including
undergarments, pullovers, front-opening shirts and blouses, managing zippers, buttons, and snaps:

0 Able to get clothes out of closets and drawers, put them on and remove them from the upper
body without assistance.
1 Able to dress upper body without assistance if clothing is laid out or handed to the patient.
2 Someone must help the patient put on upper body clothing.
3 Patient depends entirely upon another person to dress the upper body.

M1820

Current Ability to Dress Lower Body safely (with or without dressing aids) including
undergarments, slacks, socks or nylons, shoes:

0 Able to obtain, put on, and remove clothing and shoes without assistance.
1 Able to dress lower body without assistance if clothing and shoes are laid out or handed to the
patient.
2 Someone must help the patient put on undergarments, slacks, socks or nylons, and shoes.
3 Patient depends entirely upon another person to dress lower body.

M1830

Bathing: Current ability to wash entire body safely. Excludes grooming (washing face, washing
hands, and shampooing hair).

0 Able to bathe self in shower or tub independently, including getting in and out of tub/shower.
1 With the use of devices, is able to bathe self in shower or tub independently, including getting
in and out of the tub/shower.
2 Able to bathe in shower or tub with the intermittent assistance of another person:
(a) for intermittent supervision or encouragement or reminders, OR
(b) to get in and out of the shower or tub, OR
(c) for washing difficult to reach areas.
3 Able to participate in bathing self in shower or tub, but requires presence of another person
throughout the bath for assistance or supervision.
4 Unable to use the shower or tub, but able to bathe self independently with or without the use of
devices at the sink, in chair, or on commode.
5 Unable to use the shower or tub, but able to participate in bathing self in bed, at the sink, in
bedside chair, or on commode, with the assistance or supervision of another person.
6 Unable to participate effectively in bathing and is bathed totally by another person.

M1840

Toilet Transferring: Current ability to get to and from the toilet or bedside commode safely and
transfer on and off toilet/commode.

0 Able to get to and from the toilet and transfer independently with or without a device.
1 When reminded, assisted, or supervised by another person, able to get to and from the toilet
and transfer.
2 Unable to get to and from the toilet but is able to use a bedside commode (with or without
assistance).
3 Unable to get to and from the toilet or bedside commode but is able to use a bedpan/urinal
independently.
4 Is totally dependent in toileting

M1845

Toileting Hygiene: Current ability to maintain perineal hygiene safely, adjust clothes and/or
incontinence pads before and after using toilet, commode, bedpan, urinal. If managing ostomy,
includes cleaning area around stoma, but not managing equipment.

0 Able to manage toileting hygiene and clothing management without assistance.
1 Able to manage toileting hygiene and clothing management without assistance if
supplies/implements are laid out for the patient.
2 Someone must help the patient to maintain toileting hygiene and/or adjust clothing.
3 Patient depends entirely upon another person to maintain toileting hygiene.

M1850

Transferring: Current ability to move safely from bed to chair, or ability to turn and position self in
bed if patient is bedfast.

0 Able to independently transfer.
1 Able to transfer with minimal human assistance or with use of an assistive device.
2 Able to bear weight and pivot during the transfer process but unable to transfer self.
3 Unable to transfer self and is unable to bear weight or pivot when transferred by another
person.
4 Bedfast, unable to transfer but is able to turn and position self in bed.
5 Bedfast, unable to transfer and is unable to turn and position self.

M1860

Ambulation/Locomotion: Current ability to walk safely, once in a standing position, or use a
wheelchair, once in a seated position, on a variety of surfaces.

0. Able to independently walk on even and uneven surfaces and negotiate stairs with or without
railings (specifically: needs no human assistance or assistive device).
1. With the use of a one-handed device (for example, cane, single crutch, hemi-walker), able to
independently walk on even and uneven surfaces and negotiate stairs with or without railings.
2. Requires use of a two-handed device (for example, walker or crutches) to walk alone on a
level surface and/or requires human supervision or assistance to negotiate stairs or steps or
uneven surfaces.
3. Able to walk only with the supervision or assistance of another person at all times.
4. Chairfast, unable to ambulate but is able to wheel self independently.
5. Chairfast, unable to ambulate and is unable to wheel self.
6. Bedfast, unable to ambulate or be up in a chair

M1870

Feeding or Eating: Current ability to feed self meals and snacks safely. Note: This refers only to
the process of eating, chewing, and swallowing, not preparing the food to be eaten.

0. Able to independently feed self.
1. Able to feed self independently but requires:
(a) meal set-up; OR
(b) intermittent assistance or supervision from another person; OR
(c) a liquid, pureed or ground meat diet.
2. Unable to feed self and must be assisted or supervised throughout the meal/snack.
3. Able to take in nutrients orally and receives supplemental nutrients through a nasogastric tube
or gastrostomy.
4. Unable to take in nutrients orally and is fed nutrients through a nasogastric tube or
gastrostomy.
5. Unable to take in nutrients orally or by tube feeding

M1910

Has this patient had a multi-factor Falls Risk Assessment using a standardized, validated
assessment tool?

0. No.
1. Yes, and it does not indicate a risk for falls.
2. Yes, and it does indicate a risk for falls