category 4 a - oasis data set forms - Missouri Department of Health ...

Q118. [Q&A RETIRED 09/09; Duplicative of OASIS-C Guidance Manual]
[Q&A ADDED 06/05; M number updated 09/09; Previously CMS OCCB 03/05 Q&A Q
#5]
Q119. M1610. A patient is determined to be incontinent of urine at SOC. After
implementing clinical interventions (e.g., Kegel exercises, biofeedback, and
medication therapy) the episodes of incontinence stop. At the time of discharge,
the patient has not experienced incontinence since the establishment of the
incontinence program. At discharge, can the patient be considered continent of
urine for scoring of M1610, to reflect improvement in status?
A119. Assuming that there has been ongoing assessment of the patient's response to
the incontinence program (implied in the question), this patient would be assessed as
continent of urine. Therefore Response 0, no incontinence or catheter, is an appropriate
response to M1610.
Timed-voiding was not specifically mentioned as an intervention utilized to defer
incontinence. If, at discharge, the patient was dependent on a timed-voiding program to
defer incontinence, the appropriate response to M1610 would be 1 (patient is
incontinent), followed by response 0 to M1615 (timed-voiding defers incontinence).
[Q&A ADDED 08/07; Previously CMS OCCB 05/07 Q&A #23]
Q119.1. M1610. How long would a patient need to be continent of urine in order to
qualify as being continent?
A119.1. Utilize clinical judgment and current clinical guidelines and assessment findings
to determine if the cause of the incontinence has been resolved, resulting in a patient no
longer being incontinent of urine. There are no specific time frames that apply to all
patients in all situations.
[Q&A ADDED & EDITED 09/09; Previously CMS OCCB 04/08 Q&A #11]
Q119.2. M1610. How should we answer M1610 for a patient with a nephrostomy
tube? Can we interpret M1610 to mean if the urinary diversion is pouched with an
ostomy appliance it is not a catheter but if it is accessed with a tube or catheter
(external or otherwise) then the patient has a catheter? What about the patients
with continent urinary diversions? They have a stoma but are accessing
with intermittent catheterizations. Would they be reported as having a catheter on
M1620?
A119.2. When a patient has urinary diversion, with or without a stoma that is pouched for
drainage the appropriate M1620 response would be "0-No incontinence or catheter".
The appropriate response for a patient with urinary diversion, with or without a stoma,
that has a catheter or "tube" for urinary drainage would be "2 -Patient requires a urinary
catheter (i.e., external, indwelling, intermittent, suprapubic)." A patient that requires
intermittent catheterization would be represented by Response 2, even if they have
continent urinary diversions.
[Q&A EDITED 09/09]
Q120. M1615. How should I respond to M1615, When does Urinary Incontinence
Occur, for the patient with an ureterostomy?
Category 4 – OASIS Data Set – Forms and Items 09/09