OASIS · CMS Q&As
J1900: CMS OASIS Q&As
3 questions CMS has answered, quoted whole from the CMS OASIS Q&As and the 2026 quarterlies.
Since the February 2026 release: April 2026 CMS Quarterly OASIS Q&As
In the OASIS-E1 data set, J1900 - Number of Falls since SOC/ROC always contained definitions for J1900A - No injury, J1900B - Injury (except major), and J1900C - Major injury. Now in the OASIS-E2 data set, J1900B and J1900C no longer contain definitions, and instead the item description states, “As described in the OASIS manual.” Home health clinicians completing the OASIS items within their comprehensive assessments have come to rely on the definitions being there for injury (except major) and major injury. Simply stating in the official data set item language “As described in the OASIS manual” does not promote clinical ease of use, as the clinician needs to reference the definitions which have recently been revised by CMS. Can an EMR or software vendor add the definitions from the OASIS-E2 Guidance Manual for J1900B and J1900C?
In order to accurately code OASIS items, HH staff must understand the OASIS items including the coding instructions as found in the OASIS Guidance Manual, Q&A documents and other relevant CMS OASIS documents. The goal of these resources is to provide HH staff with the rationale and guidance necessary to accurately complete each OASIS item. As stated in the final OASIS-E2 Guidance Manual for J1900 - Number of Falls since SOC/ROC, major injury includes but is not limited to traumatic bone fractures, joint dislocations/subluxations, internal organ injuries, amputations, spinal cord injuries, head injuries, and crush injuries. The injuries listed in J1900B - Injury (except major) and J1900C - Major injury are examples and should not be considered an all-inclusive list. HHAs are required to incorporate the OASIS data items exactly as written into the agency's comprehensive assessment. In addition to any required OASIS items, an agency may determine what other language will be included in the agency’s comprehensive assessment(s) to meet regulatory, coverage and clinical needs. While the item language and response options may not be modified, reformatting of the presentation of the item is left to the user’s discretion, as long as such modification is presented in a way that makes it clear which items (assessment questions and response options) are part of the OASIS, and which are not.
Our agency has been reviewing the updated information and guidance related to the respecified Falls with Major Injury quality measure. Since the updated definition in the OASIS-E2 Guidance Manual for major injury provides a list of injuries/conditions and states the definition of major injury for J1900 - Number of Falls since SOC/ROC “includes but is not limited to” the conditions offered, in order to have consistency within our assessments, can our clinicians define a major injury for J1900C - Major injury based on the ICD-10 codes used to identify major injuries for the quality measure, as listed in Appendix B of the Fall with Major Injury Respecification Technical Specification Report?
As indicated for J1900 - Number of Falls since SOC/ROC, a major injury includes but is not limited to traumatic bone fractures, joint dislocations/subluxations, internal organ injuries, amputations, spinal cord injuries, closed head injuries, and crush injuries. While not required, an agency may utilize Appendix B. Major Injury Diagnostic Codes of the Home Health - Falls with Major Injury Respecification Technical Specification Report in defining a major injury for J1900C - Major injury.
If a home health patient has a fall, but the physician specifies a pathological fracture diagnosis for the resulting injury, we understand that J1800 - Any Falls Since SOC/ROC would be coded 1 - Yes. When this occurs how should J1900 - Number of Falls since SOC/ROC be coded?
Fractures confirmed to be pathologic (vs traumatic) are not to be considered a major injury resulting from a fall for the purpose of coding J1900 - Number of Falls since SOC/ROC. Therefore, the fall would be reported in J1800 - Any Falls Since SOC/ROC, but the pathological fracture would be specifically excluded as being coded as an injury resulting from the fall. If, in the scenario, there were no other falls and no injuries related to a fall during the home health quality episode, then J1900 - Number of Falls Since SOC/ROC would be coded as the following: J1900A - No Injury = 1 J1900B - Injury (except major) = 0 J1900C - Major injury = 0
Also mentioned in
Source: April 2026 CMS Quarterly OASIS Q&As (April 2026), text extracted from the PDF with pdftotext, retrieved 2026-10-09. Works of the US Government are in the public domain.
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