Harmony Healthcare Blog

MDS 3.0 Section GG Coding Examples

Posted by The Harmony Team on Thu, Oct 13, 2016

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


mds_gg.jpgIs your facility capturing the most accurate data for coding in the new Section GG of the MDS 3.0?  If Section GG is still causing you and your facility anxiety, you are not alone.  Below you will find a list of Coding Examples for Section GG.  We hope that such examples will aid in the understanding of these new regulatory changes.

Eating

Scenario 1:  Mrs. Davis prefers to do all of her ADLs as independently as possible.  She is able to feed herself after she is set up.  Mrs. Davis is often too tired to finish her meal and the CNA will feed her the last few bites, and bring the cup to the patient’s mouth.

Q:  How will Section GG0130A be coded?
A:  The Correct code is “03” moderate partial assist.  Rational because the CNA is feeding her only the last few bites the patient is completing more than 50% of the task.

Scenario 2:  Mr. Hill is unable to eat by mouth due to his medical condition.  He receives nutrition through a gastrostomy tube (G-tube), which is administered by nurses.

Q:  How will Section GG0130A be coded?
A:  The correct code would be “88” because he is unable to eat by mouth due to his medical condition

Oral Hygiene

Scenario:  Mr. W is edentulous and his dentures no longer fit, so he refuses to wear them.  Mr. W is encouraged to brush his gums and he begins by brushing his upper gums after the CNA puts toothpaste onto his toothbrush.  He brushes his upper gums, but cannot finish due to fatigue.  The CNA completes the activity of oral hygiene by brushing his back upper gums and his lower gums.

Q:  How would you code GG0130B?
A:  The correct code is “02 substantial/max assist because although he is edentulous oral care is being provided.  The patient completes only the front upper gums and the staff completes the remainder which is greater than 50%.

MDS 3.0. Resident Assessment And Care Screening Forms

Toileting Hygiene

Scenario:  Even though she has been instructed not to do so, Mrs. Green will transfer herself independently to the toilet each time she needs to go.  Once she is finished, she will ring the bell for a nurse.  The nurse provides steadying assist as she wipes herself and pulls up her underpants unassisted.

Q:  How would you code GG0130C?
A: 
The correct code is “04” supervision/touching assist since the patient completes the task with only steadying assist

Sit to Lying

Scenario:  Mrs. H requires assistance from two CNAs to transfer from sitting at the edge of the bed to lying flat on the bed.   One of the CNAs explains to Mrs. H each step of the sitting to lying activity.  Mrs. H is then fully assisted to get from sitting to a lying position on the bed.

Q:  How would you code GG0170B?
A:
  The correct code is “01” dependent since two staff assist with the task

Bed to Chair Transfer

Scenario:  Ms. P is motivated to assist with her transfers from the side of her bed to the wheelchair.  Ms. P pushes herself up from the bed to begin the transfer while the therapist provides trunk support.  Once standing, Ms. P shuffles her feet, turns, and slowly sits down into the wheelchair with the therapist providing trunk support. Overall, the therapist provides less than half of the effort.

Q:  How would you code GG0170E?
A: 
The correct code is “03” since the therapist completes less than ½ of the task

Toilet Transfers

Scenario:  Mrs. Bell is anxious about getting up to use the bathroom.  She asks the CNA to stay with her in the bathroom as she gets on and off the toilet.  The CNA stays with her, as requested, and provides verbal encouragement and instructions (cues).

Q:  How would you code GG0170F?
A: 
The correct code would be “04” supervision/touching assist

Walk 50 Feet with 2 Turns

Scenario:  Mrs. L is unable to bear her full weight on her left leg.  As she walks 60 feet down the hall with her crutches and makes two turns, her therapist supports her trunk.  The therapist provides less than half the effort.

Q:  How would you code GG0170J?
A: 
The correct code is “03” since the therapist does less than half.

Harmony Healthcare International (HHI) is available to provide onsite analysis and associated medical record reviews to help you improve your Quality Measure Scores.  Please contact Harmony Healthcare International by clicking here or calling our office at 1.800.530.4413.


 

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To Learn More about Section GG and Upcoming Regulatory Changes!
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Topics: Section GG, MDS Section GG

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