Flu Season is Here: Flu Vaccines and OASIS Assessment Reminders

Posted on Friday, October 26, 2018 12:16 PM

Flu Vaccine and OASIS Assessment: What You Need to Know
By: Amanda Gartner RN, BSN, MSN, COS-C, Clinical Analytics Manager at Corridor

We are now in the midst of flu season and our coding reviewers will be looking closely at the M1041 Influenza Vaccine Data Collection Period to see if the episode of care includes any dates on or between October 1 and March 31.

M1041 is a data timepoint question, so if any part of the quality episode is between Oct 1^st – March 31^st the answer will be Yes: Response 1.

Episode of care = quality episode

• Transfer/Discharge looking back to include most recent SOC/ROC – if any of this period happened between Oct 1^st and March 31^st M1041 will be 1-Yes
• Example: SOC 8/12 and discharged 9/29.
  M1041 Response: 0, No
• Example: SOC 8/12 and Recert 9/30 and Discharge Oct 4^th
  M1041 Response:1, Yes

The CDC recommends that people get a flu vaccine by the end of October but can be administered as soon as August 1^st for the current 2018 flu season. (See Table)

M1046 If M1041 is Yes then M1046, “Did the patient receive the influenza vaccine for this year’s flu season?”, will be reviewed. Many EMRs have a place to record if the patient received a flu vaccine for the current flu season or in prior years.

This information is imperative for Corridor to be able to reconcile and validate the M1046 OASIS response. If vaccine history is left blank, reviewers are not able to ensure the OASIS item is answered appropriately. Patients may have received the flu shot for the current flu season; however, the clinician has not updated the vaccine history in the chart and then answered M1046 with “Response 4 – offered and declined” inadvertently. Because the vaccine history was not provided, we are not able to reconcile or change the OASIS response.  

Please see some scenarios below for how 1-3 responses could apply.

• Response 1 = Your agency provided flu vaccine during this episode of care 
• Example:
  SOC 9/24 and discharge 10/1
  Patient received flu vaccine for this current flu season from your agency on 9/25.
  M1041: Is this quality episode between Oct 1^st – March 31^st?

M1041: Response 1, Yes

M1046: Did the patient receive a flu vaccine for this flu season?
M1046: Response: 1, Yes; your agency provided flu vaccine during this episode of care

• Response 2- Received from your agency during a prior episode of care  
• Example:
  You gave vaccine in Sept. and discharged in Nov. Then you readmitted patient in Jan. and now discharging in February
  M1041: Is this quality episode between October 1^st– March 31^st?
  M1041 Response: 1, Yes
  M1046: Did the patient receive a flu vaccine for this flu season?
  M1046 Response: 2, Yes; received from your agency during a prior episode of care

• Response 3 = Another health care provider gave flu vaccine. Pt/cg reports patient received vaccine for current flu season from another provider
• Example:
  SOC 9/30 and H&P states patient was given flu shot while in hospital on 9/20; patient discharged 10/5.
  M1041: Is this quality episode between October 1^st– March 31^st?
  M1041 Response: 1, Yes

M1046: Did the patient receive a flu vaccine for this flu season?
M1046 Response: 3: Yes; received from another health care provider  

As a reminder Flu Vaccine History has been removed from the 5-star patient quality calculations this past year. It is also being proposed to be removed from the Value Based Purchasing Model as written in the 2019 Home Health Rulings.

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About Corridor

Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

For additional information, please contact Corridor at 1-866-263-3795.

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