For the hearing section, B0200, the patient reported, "I have trouble following normal conversations, especially when a lot of different people are talking at the same time. I can usually make out what someone is saying if they talk a little louder and make sure they speak clearly and I can see their face when they are talking to me." What would be the best response to B0200 Hearing?
Answer
The coding instructions are as follows for the section on Hearing:
Code 1. Minimal difficulty. The patient hears speech at conversational levels but has difficulty hearing when not in quiet listening conditions or when not in one-on-one situations. The patient’s hearing is adequate after environmental adjustments are made, such as reducing background noise by moving to a quiet room or by lowering the volume on the television or radio.
Code 2. Moderate difficulty. Speaker has to increase the volume and speak distinctly. Although hearing deficient, the patient compensates when the speaker adjusts tonal quality and speaks distinctly; or the patient can hear only when the speaker’s face is clearly visible.
Code 3. Highly impaired. Absence of useful hearing. The patient hears only some sounds and frequently fails to respond even when the speaker adjusts tonal quality, speaks distinctly, or is positioned face-to-face. There is no comprehension of conversational speech, even when the speaker makes maximum adjustments.
The patient has difficulty hearing people in conversation, but comprehension is improved when the speaker makes adjustments like speaking at high volume, speaking clearly, and sitting close by so that the speaker’s face is visible. So the correct coding assessment would be Moderate difficulty.
This Ask the Expert is an edited excerpt from the course, OASIS E: New Items,by Cindy Krafft, PT, MS, HCS-O, K&K Health Care Solutions
Cindy Krafft, PT, MS, HCS-O
Cindy Krafft PT, MS, HCS-O is an owner of K&K Health Care Solutions based in Florida. She brings more than 25 years of home health expertise that ranges from direct patient care to operational / management issues as well as a passion for understanding regulations. For the past 15 years, Cindy has been a nationally recognized educator in the areas of documentation, regulation, therapy utilization, and OASIS. She has and currently serves on multiple Technical Expert Panels with CMS Contractors working on clinical and payment reforms and bundled payment care initiatives. Her focus is on providing the knowledge and tools critical to the post-acute continuum of care to operationalize external requirements while keeping the driver of care where it needs to be – the needs of each patient being cared for.
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