OASIS-E2 Item Guide
Item-by-item coding references for the OASIS-E2 items coders and clinicians look up most. Each guide is checked against the CMS OASIS-E2 Guidance Manual and links to the source.
The Short Answer
OASIS-E2 took effect April 1, 2026, and Chapter 3 of the free CMS guidance manual is the official item-by-item reference. The guides below condense the items behind most coding questions: the ADL items behind the PDGM functional level, Section GG, diagnosis coding, oral medication management, and pressure ulcers. Each one states the response scale, the time points, the common errors, and the CMS source.
The Item Guides
M1800-M1860
ADL Items
Grooming, dressing, bathing, toilet transferring, transferring, and ambulation: response scales, scoring errors, and how they set the PDGM functional level.
GG0130 / GG0170
Self-Care and Mobility
The 6-point scale, codes 07, 09, 10, and 88, usual performance, time points, and why the discharge goal column is gone.
M1021 / M1023
Diagnosis Coding
Primary and other diagnoses: sequencing, symptom control ratings, symptom codes, the PDGM clinical group link, and M1028.
M2020
Management of Oral Medications
Response levels, ability not willingness, which routes count as oral, item uses, and common errors.
M1311
Pressure Ulcers/Injuries
Stages 2-4, the three unstageable rows, what stays out, discharge rules, and M1306, M1322, and M1324.
Time Points at a Glance
From Appendix B of the OASIS-E2 manual. FU means Follow-up, including recertification.
| Item | SOC | ROC | FU | DC | Uses listed by CMS |
|---|---|---|---|---|---|
| M1800-M1860 | X | X | X | X | PDGM payment, quality, risk adjustment. M1810-M1830 also HHVBP. |
| GG0130 / GG0170 | X | X | Subset | X | Quality, risk adjustment, HHVBP for selected activities |
| M1021 / M1023 | X | X | Risk adjustment. M1021 also quality and HHVBP. | ||
| M1028 | X | X | Risk adjustment | ||
| M2020 | X | X | X | Quality, risk adjustment, HHVBP | |
| M1311 | X | X | X | Quality, risk adjustment |
Rules for Every Item
Chapter 1 of the manual lists conventions for all OASIS items. The ones behind most coding errors:
- Day of assessment. Unless an item says otherwise, code status during the 24 hours before the visit plus the time in the home.
- The 50% rule. If status varies, report what is true more than 50% of the time under consideration.
- Assess, don't copy. Base current status on observation and report at this assessment, not on prior assessments or another setting's records. Direct observation is preferred for functional and physiological items.
- Assistance means a person. When an item refers to assistance, it means another person, including verbal cues and supervision.
- Dashes are rare. A dash means no information. Many items do not allow one.
- Follow skip patterns and the item's own definitions. "Specifically" limits an item to the listed cases. "For example" leaves room for others.
- Collaboration has limits. Agency policy decides whether other staff contribute, and their input must fall inside the assessment timeframe, and the assessing clinician signs.
- Software does not code. The manual bars agency software from answering or generating a final code for any OASIS item. The assessing clinician is responsible for the final response.
How to Use These Guides
QA reviewers and educators get the most from the guides with a fixed routine for each question:
- Confirm the version. The assessment date decides the manual. On or after April 1, 2026 means OASIS-E2.
- Check the time point. Several items, such as M1021 and M1311, are not collected at Follow-up. Do not code an item the time point does not include.
- Read the intent and the response-specific instructions. Most errors come from counting a task the item excludes.
- Cross-check related items. M1306 against M1311, the ADL items against Section GG, and M1021 against the claim's principal diagnosis.
- Search the OASIS Q&As for edge cases the manual text leaves open.
- Escalate to CMS. The manual directs unresolved questions to the Home Health Quality Help Desk at HomeHealthQualityQuestions@cms.hhs.gov.
Payment Items vs Quality Items
Appendix B marks only eight OASIS-E2 items for PDGM payment: M1800, M1810, M1820, M1830, M1840, M1850, M1860, and M1033 Risk for Hospitalization. Their points set the functional impairment level. The other PDGM variables come from the claim: the principal diagnosis sets the clinical group, and the secondary diagnoses set the comorbidity adjustment. Section GG, M2020, and M1311 drive quality measures, risk adjustment, and, for some activities, HHVBP. They do not change the PDGM case-mix group. See the PDGM overview for the full model.
What Changed for These Items in OASIS-E2
OASIS-E2 is a minor revision. None of the items in these guides gained or lost response options. Appendix D records these guidance updates:
- M1840: incontinence on the way to the toilet counts only if it affects the ability to get there and transfer safely.
- GG0170: the assessor's presence does not count as supervision. Ramps and elevators do not substitute for steps.
- M1311: the graft coding tip now says "treated surgically" with a graft.
The larger Section GG change came a year earlier. OASIS-E1 removed the discharge goal column from GG0130 and GG0170 on January 1, 2025. For the full E1-to-E2 list, see what changed in OASIS-E2.
Where Documentation Goes Wrong
Most item errors come from a gap between the visit and the form: a walker mentioned in conversation but missing from M1860, or a daughter who fills the pill box but an M2020 of 0. Lime's OASIS Scribe drafts OASIS responses from the visit conversation and flags inconsistencies so your QA team corrects them before submission. The assessing clinician confirms every final response.
More OASIS-E2 References
- The OASIS-E2 manual: where to download it free from CMS and which version applies to your assessment date.
- OASIS-E2 checklist: a quick reference for clinicians and QA reviewers.
- What is OASIS? The assessment, its history, and why it matters.
CMS Sources
- OASIS-E2 Guidance Manual (PDF), effective April 1, 2026.
- CMS OASIS User Manuals page, with the OASIS Q&As.
- CMS OASIS Data Sets page, with the item sets.
- CY 2026 Home Health PPS final rule, for PDGM functional scoring.
FAQ
OASIS-E2 Items, Answered
Common questions on finding and applying OASIS-E2 item guidance.
Chapter 3 of the CMS OASIS-E2 Guidance Manual covers every item, with intent, time points, response-specific instructions, coding instructions, and examples. CMS posts the manual free on its OASIS User Manuals page. The guides on this page summarize the items coders and clinicians search for most.
Appendix B of the OASIS-E2 manual marks M1800, M1810, M1820, M1830, M1840, M1850, M1860, and M1033 as PDGM payment items. These set the functional impairment level. The clinical group and comorbidity adjustment come from the diagnoses on the home health claim.
April 1, 2026. Assessments dated on or after April 1, 2026 follow OASIS-E2. Assessments dated January 1, 2025 through March 31, 2026 follow OASIS-E1.
Their response options did not change. E2 added coding tips, including an M1840 tip on incontinence and a Section GG tip saying the assessor's presence is not supervision. The bigger GG change came earlier: CMS removed the GG discharge goal with OASIS-E1 in January 2025.
No. The OASIS-E2 manual bars agency software from answering or generating a final code for OASIS items. Software and AI tools draft responses and flag problems for review, but the assessing clinician is responsible for the final response.
Unless an item says otherwise, the look-back is the 24 hours before the assessment visit plus the time the clinician spends in the home. If status varies during the period, report what is true more than 50% of the time.
Cut OASIS documentation time by 75%.
See OASIS Scribe