Tips for Coding OASIS N0415 High-Risk Drug Classes 

by Kerry Termine, DPT, HCS-D, COS-C

Understanding the home health coding of the new OASIS N0415 High-Risk Drug Classes: Use and Indication item.

Home health agencies began collecting OASIS data for item N0415 High-Risk Drug Classes: Use and Indication with the launch of OASIS-E on January 1, 2023. The intent of this post-acute care cross setting item is to record whether:

  1. The patient is taking any medications in high-risk drug classes, and there is a patient-specific indication noted and the patient/caregiver has been educated about the high-risk medications,
  2. A drug regimen review was conducted, and
  3. The patient can manage oral and injectable medications.

What is N0415 – High-Risk Drug Classes?

This item is asking the assessing clinician to review the patient’s current reconciled drug regimen while they are a patient of the home health agency. It then data collects on two points:

  • Based on the patient’s current reconciled drug regimen, is the patient taking any prescribed medicines that could be classified into one of six drug classes (Antipsychotic, Anticoagulant, Antibiotic, Opioid, Antiplatelet, and Hypoglycemic – including insulin), and if so
  • Do those prescribed medicines also have an indication noted that is specific to that patient?

Data for this item is collected on the OASIS at Start of Care (SOC), Resumption of Care (ROC) and Discharge assessments.

Tips for coding N0415

  • Current Reconciled Drug Regimen – Code a medication that is part of a patient’s current reconciled drug regimen, even if it was not taken at the time of assessment.
    • This could include new medications the patient has not started.
    • This could include medications that have a frequency of every few weeks or monthly.
  • No CMS Resources for Drug Class – CMS does not specify a resource for determining drug classification and/or therapeutic category.
  • No Need for Drug Class to Match Reason for Use – The drug classification does not have to match the reason why the patient is taking that medicine. If the medicine falls into one of the drug classifications and has a patient-specific indication noted, then both column 1 and 2 should be checked for that drug.
  • Drugs in More than One Class – If a single drug could be classified into two different drug classes, then both drug classes should be checked for that drug.
  • Don’t Include Herbal and Alternative Meds – Herbal and alternative medicine products should not be considered when answering this question, even if they are a part of the current reconciled medication drug regimen.
  • Discharge Consideration – Do not code N0415 based on what is expected to occur at discharge.
  • Don’t Code Flushes for IV Ports – Flushes used to keep an IV port patent should not be coded in N0415.
  • Coding None of the Above
    • If at least one of the drug classes A-J is selected, then Z – None of the above should not be selected.
    • If Z – None of the above is selected, then no drug classes A-J should be selected.

Learn more about the intricacies of accurate OASIS coding at an upcoming Blueprint for OASIS Accuracy Workshop. We hope to see you soon!

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