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Jurisdiction 11 Home Health and Hospice
Would I report G0163 for doing an OASIS assessment?

If the only reason for the visit is to do the OASIS assessment, then the answer is no. The intent of Change Request 7182 is for the Centers for Medicare & Medicaid Services (CMS) to more fully understand the reason for the skilled nursing visit. The new G-Codes describe three possible skilled nursing services that may be covered by Medicare. These descriptions are the first three skills listed under nursing in the CMS home health coverage manual. Descriptions of services that may be considered skilled nursing visits under the home health Medicare benefit are available at CMS's Internet Only Manual Web Page. Select CMS Internet-Only Manual (IOM) Publication 100-02 (Medicare Benefit Policy Manual); Chapter 7; Section 40.1.1 (PDF, 455 KB).

If, in the course of making a visit to do the OASIS assessment, the nurse also performs a skilled service which fits the description in the coverage manual for skilled services of a licensed nurse (Licensed Practical Nurse (LPN) or Registered Nurse (RN)) for the Observation and Assessment of the patient’s condition, therefore qualifying the visit as a billable visit, then G0163 may be reported on the claim.


last updated on 06/29/2015
ver 1.0.51