Protocol Revision | More Than 10% Patient Records with Missing Procedural Codes
folder_openSurvey Specifications and Guidelinescalendar_todayPosted January 31, 2023
In preparation for linking participation in the OAS CAHPS Survey to reimbursement, CMS has revised the requirements for when the percentage of patient records (in a monthly patient file) with missing procedural codes is more than 10%. When this occurs, vendors must do the following starting with the January 2023 sample month:
- Proceed with sampling;
- Field the OAS CAHPS Survey; and
- Submit a Discrepancy Notification Report (DNR).
For the DNR submission documenting more than 10% missing codes, vendors must submit an online DNR and an accompanying Excel file (using the template available through the online DNR form). In the "Missing Procedural Codes" tab of the DNR Excel file, include the following:
- The percentage of patient records with missing procedural codes at the time of sampling and at the time of data submission,
- The number of affected patient records at the time of sampling and at the time of data submission, and
- The steps taken to get updated information and confirm eligibility.
Documentation of these changes have been incorporated into the OAS CAHPS Survey Protocols and Guidelines Manual, Version 7.0, Introduction to the OAS CAHPS Survey Training slides (from the fall 2022), and the online DNR form. Below highlights the changes made to each of these items:
- OAS CAHPS Survey Protocols and Guidelines Manual, Version 7.0
- Chapter IV (revised bottom box of flowchart graphic on page 46, and revised protocols regarding more than 10% missing codes on pages 48 and 49).
- Chapter XVII (revised example instance when DNR is needed regarding more than 10% missing codes on pages 279 and added new Discrepancy Reason to Table 17.1 on page 280).
- Appendix O (updated to reflect changes made to online DNR form noted below).
- Introductory Training slides
- Sampling module - slides 79, 80 and 81.
- Exceptions Request and Discrepancy Notification Reports module - slides 446, 447, and 449.
- DNR form
- Added "Missing Procedural Codes" to Discrepancy Reason dropdown list.
- Added checkbox vendors use to indicate submitting an accompanying Excel spreadsheet.
- Added DNR Excel spreadsheet template that is required to be submitted if "Missing Procedural Codes" Reason is selected.
Please contact the OAS CAHPS Survey Coordination Team via e-mail at firstname.lastname@example.org or call toll-free (866) 590-7468, if you have any questions.