OASIS-Central

Influenza Data Element Guidance

M1040: Influenza Vaccine: Did patient receive the influenza vaccine from your agency for this year’s influenza season (October 1 through March 31) during this episode of care? Definition of episode of care is from SOC/ROC to transfer or discharge Question should be answered “yes” or “no” if any portion of the episode falls within the [...]

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Flu/Pneumonia Vaccinations: Screening and Assessment

The following are best practice guidelines for the screening and assessment of flu or pneumococcal pneumonia in homecare patients: • Starting in September, have your flu champion implement a training program that will instruct clinicians to educate patients about the importance of the flu vaccine. Be sure clinicians understand that many patients will refuse immunization [...]

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Can our agency bill Medicare for one skilled nursing visit to administer the flu vaccine if the patient is currently active and we get a physician’s order?

Q: Can our agency bill Medicare for one skilled nursing visit to administer the flu vaccine if the patient is currently active, receiving other skilled services, and we get a physician’s order? A: In 2002, the Centers for Medicare and Medicaid Services (CMS) determined it was not necessary for an agency to obtain orders to [...]

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National Influenza Vaccination Week

In honor of  National Influenza Vaccination Week which runs 1/10 to 1/16, here are some tips about vaccine administration and billing. You do not need an order to administer the flu or pneumonia vaccines; however, there is no similar stipulation regarding epinephrine. Medicare coverage: Medicare Part B pays for both the vaccine and administration Administration [...]

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How do we answer M1040 if we administer the flu vaccine, but do not supply it?

Q: Our agency administers the flu vaccine but we do not supply the drug. We go to the patients PCP and get the drug, take it to the patients home and administer. How would we answer M1040? One of my supervisors heard that if the agency did not supply the drug the answer is no. [...]

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Flu and Pneumonia Data Elements

With winter officially upon us, here is some important information regarding flu and pneumonia data elements. Flu vaccine • M1040, influenza vaccine, and M1045, reason influenza vaccine received • Data elements apply at transfer and discharge if the episode overlapped the flu season (October 1 through March 31) • Data element asks about flu vaccine [...]

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