M0102: Physician Ordered SOC or ROC

Do you know when a date should be entered in M0102 versus M0104?

M0102 can be a very confusing item in the OASIS for some clinicians and agencies. What exactly is a physician-ordered start of care (or resumption of care) date? Some people make this item a lot more complicated than it needs to be. Let’s look at the item wording.

“If the physician indicated a specific start of care (resumption of care) date when the patient was referred for home health services, record the date specified.”

There is further guidance from CMS in the OASIS Guidance Manual on this item

“If the originally ordered start of care is delayed due to the patient’s condition or physician request (e.g. extended hospitalization), then the date specified on the updated/revised order to start home care services would be considered the date of physician-ordered start of care (resumption of care).”

There is one caveat though. This extended order needs to be received before the end of the 48 hour initial assessment time frame or before the date of the previously ordered SOC date. If the order is received after that time frame, response NA should be used in M0102 and the original referral date used for M0104.

What constitutes as an official physician-ordered SOC date?

The physician or physician designee needs to give a specific order that the SOC/ROC is to be done on a specific date. I can’t emphasize enough that it needs to be a specific date, it can’t be a range of dates or something vague. Anything other than a referral that directs the SOC/ROC to be on a specific date should be treated as a normal referral and the response in this item would be NA.

In general, most home care referrals do not have a specified SOC/ROC in them, though there may be certain physicians who typically order specific dates for certain types of patients. Here’s an example: A patient is being discharged home today, February 2nd, with an IV, feeding tube, or wound vac and the SOC needs to be on February 3rd, the day after discharge.

Please note that a patient request does not count as a date for this item. A date in this item needs to be directed by the physician. And if the physician lists a specific SOC date and the SOC isn’t performed on that date, there needs to be documentation to support why this didn’t happen. That’s always the best advice – make sure to thoroughly document everything and keep in communication with the physician and/or their office to help be as accurate as possible with this item.