M1200 is an OASIS item that is often answered incorrectly, and since this item receives case mix points in equations "1" and "4", you may be upcoding your OASIS without knowing. For years, many clinicians have assumed incorrectly that all elderly patients have "impaired vision" when it comes to answering the OASIS item related to vision. The criteria for scoring a patient with impaired vision in M1200 (formerly M0390) is often overlooked.

According to OASIS Item Guidance, a patient's vision should be assessed with corrective lenses if the patient normally wears them. Corrective lenses include prescription lenses and drugstore reading glasses. A magnifying glass, however, does not qualify as a corrective lens. It is essential to ensure the documentation in the clinical record supports your response to this item.

M1200 response "1 - partially impaired" vision indicates a patient "cannot see medication labels or newsprint, but can see obstacles in path, and the surrounding layout; can count fingers at arm's length". Documentation that contraindicates a response of impaired vision is often seen in clinical records, e.g., "patient sitting in recliner reading the newspaper". In order to answer this item appropriately with response "1", the patient must not be able to see newsprint with corrective lenses (if the patient normally wears them).

Click here and review the OASIS-C item guidance for M1200 to ensure that you answer M1200 correctly without upcoding your OASIS.

Kristi R. Wheeler, RN, HCS-D, COS-C is a Clinical Consultant for Kinnser Software, Inc., and the owner of ACCS (Agency Compliance & Consulting Service, LLC.), a company specializing in comprehensive OASIS review and ICD-9 coding. ACCS has a highly trained staff of nurses who have both the HCS-D and COS-C certifications. For more information, contact Kristi at kristi.wheeler@accscoder.com or (469)834-3664.