OASIS edit -4421
Edit -4421 is a fatal skip pattern edit in CMS's OASIS-E2 data specifications V3.02.0, effective for records with completion dates on or after 2026-04-01. A fatal edit rejects the record: "Records with fatal errors will be rejected. All fatal errors in a record must be corrected and resubmitted." It checks 2 items: M2001_DRUG_RGMN_RVW, M2003_MDCTN_FLWP. CMS's action: "Make appropriate corrections to the records and resubmit."
What CMS's data specification says about -4421
CMS's OASIS-E2 Data Submission Specifications V3.02.0 (HTML edit page oe_4421.html, generated 11/05/2025) list edit -4421 with edit type Skip pattern and severity Fatal. The edit text, as CMS publishes it:
If M2001_DRUG_RGMN_RVW=[0], then M2003_MDCTN_FLWP must equal [^].
CMS's overview document defines this edit type: "Skip patterns always involve two or more items. The first item in the group is designated the trigger (or gateway) item. The value of the trigger item determines whether the remaining items are answered by the assessor or are skipped."
What the iQIES error message for -4421 says
CMS's OASIS Error Message Reference Guide v2.4 (Excel, posted 2026-02-05 on the QTSO reference manuals page) has 1 current entry for this edit. Each is copied in full, with whitespace normalised:
-4421
- Error ID
- -4421
- Severity
- Fatal
- Type
- Skip
- Error message
- If M2001_DRUG_RGMN_RVW=[0], then M2003_MDCTN_FLWP must equal [^].
- Potential cause
- The value submitted in M2003 (Medication Follow-up) is not consistent with the value submitted in item M2003 (Drug Regimen Review).
- Tips
- IF M2001 is 00,THEN M2003 must be skipped (^).
- Action
- Make appropriate corrections to the records and resubmit.
- Effective start date
- 2017-01-01
- Effective end date
- 2099-12-31 (CMS uses this date for an open-ended entry)
Items this edit checks
CMS's Item List for -4421 names 2 items.
Related edits
Other current edits whose CMS Item List shares one or more items with -4421 (the broad -3060 value edit, which covers 365 items, is left out):
What happens to the record
CMS's overview, section 6.4, on fatal edits: "Violation of a fatal edit will result in rejection of the submission file." CMS's iQIES error message guide: "Records with fatal errors will be rejected. All fatal errors in a record must be corrected and resubmitted."
Which records this edit applies to
Data specifications version 3.02 has an effective start date of 2026-04-01 and no end date (CMS overview, Table 1). CMS selects the edit set by the record's completion date: "When a submitted record is validated by the iQIES system, its completion date is evaluated and is used to load the appropriate set of edits for the specifications in effect on that date."
Frequently asked questions
Is OASIS edit -4421 fatal or a warning?
Fatal. CMS lists edit -4421 with severity Fatal in the OASIS-E2 data specifications V3.02.0. The CMS overview states: "Violation of a fatal edit will result in rejection of the submission file." The iQIES error guide adds: "Records with fatal errors will be rejected. All fatal errors in a record must be corrected and resubmitted."
Which OASIS items can trigger edit -4421?
CMS's Item List for edit -4421 names 2 items: M2001_DRUG_RGMN_RVW, M2003_MDCTN_FLWP. The full list with descriptions is in the table above.
How do I fix OASIS edit -4421?
CMS's OASIS Error Message Reference Guide v2.4 gives this action for -4421: "Make appropriate corrections to the records and resubmit." Its tips: "IF M2001 is 00, THEN M2003 must be skipped (^)."
Which records does edit -4421 apply to?
Under version 3.02 of the data specifications, records whose completion date, item M0090_INFO_COMPLETED_DT, is on or after 2026-04-01, the effective start date CMS gives that version. Records completed earlier are checked under the version in effect on their completion date (CMS overview, Table 1 and section 3.2); the effective start date on each guide entry above is the date CMS's error guide gives that entry. The CMS overview states: "When a submitted record is validated by the iQIES system, its completion date is evaluated and is used to load the appropriate set of edits for the specifications in effect on that date."
Sources
- CMS, OASIS-E2 Data Submission Specifications V3.02.0 FINAL (zip): HTML edit page
oe_4421.htmland the Unduplicated Edits By ID Report. https://www.cms.gov/files/zip/oasis-e2-data-specs-v3-02-0-final-zip.zip (download page: https://www.cms.gov/medicare/quality/home-health/data-specifications) - CMS, OASIS Data Submission Specifications Overview, Version 3.02.0, October 29, 2025 (in the same zip).
- CMS QTSO, OASIS Error Message Reference Guide v2.4 (Excel), posted 2026-02-05. https://qtso.cms.gov/system/files/qtso/OASIS%20Error%20Message%20Reference%20Guide%20FINAL%202.4.26.xlsx
CMS text on this page is copied from CMS's documents without rewording; whitespace is normalised, and one rendering artifact in CMS's HTML (a double quote standing in for an apostrophe) is corrected to the apostrophe in CMS's PDF report. This page is maintained by Logicly, which is not affiliated with CMS. Checked against the CMS files on 2026-10-16.