Coding
Misc
Misc
The UAS
The MMSE
Code this Pic
100
The member's son reports the member has been forgetful and even forgot how to use his microwave. The member does not need any supervision to maintain his safety. His son does report that the member has some difficulty making decisions in new situations only.
The best UAS selection for Cognitive Skills for Daily Decision-Making question would be:
- Independent
- Modified Independence
- Minimally Impaired
- Moderately Impaired
- Modified Independence
Making decisions regarding tasks of daily life - e.g., when to get up or have meals, which clothes to wear or activities to do
100
Your member has a spinal injury at L-4 and must bathe in bed. He can wash his own upper body, but the aid must completely wash his legs, back, and hair due to his inability to bend at the waist. You observe the PCA lift his legs up one at a time to cleanse his lower extremities. What is the best code selection for this member for Bathing?
Independent, setup help only
Extensive assistance
Maximal assistance
Total Dependence
Extensive assistance - Weight-bearing support by 1 helper where person still performs 50% or more of sub-tasks.
Bathing - How takes bath or shower. Includes how transfers in and out of tub or shower AND how each part of body is bathed: arms, upper and lower legs, chest, abdomen, perineal area - EXCLUDE WASHING OF BACK AND HAIR.
100
You had an assessment visit with your member yesterday at 10am and created a UAS in the Health Commerce System. What is the deadline to sign and finalize your UAS?
24 hours (or by today at 10am).
*For Friday assessments it is highly recommended that you finalize and attach documents by COB Friday.
100
The Community Health Assessment (CHA) is the main assessment in the Health Commerce System. Which supplemental assessment is ALWAYS completed with the CHA?
What is The Functional Supplement.
100
How does an assessor communicate to the Care Manager (CM) that the member's loss of points from their MMSE score is due to non-cognitive deficits, such as amputations or illiteracy?
The assessor must subtract the point value of the items the member cannot complete due to their non-cognitive deficits from the denominator and legibly write the reason for the adjustment on the back of the MMSE form.
*Auditors will take points for illegible MMSEs.
100
Based on this image, how would you code this member for ambulation? 
Maximal assistance - Weight-bearing support by 2 helpers.
200
Member’s son has taken over responsibility for bill payment after the member forgot to pay her electric bill and her electricity was turned off. The son will also make cash withdrawals for the member from the ATM when the member asks. Based on this information, the best UAS response for Finances, both Performance and Capacity, would be:
Independent
Setup help only
Extensive Assistance
Maximal Assistance
Maximal Assistance.
Managing finances - How bills are paid, checkbook is balanced, household expenses are budgeted, credit card account is monitored.
200
You are with your member who is still suffering the late effects of his stroke one year ago. He has difficulty finding words and finishing thoughts but if given time, little or no prompting is required. How would you code this member for Making self understood (expression)?
Understood
Usually Understood
Often Understood
Sometimes understood
Usually understood - Difficulty finding words or finishing thoughts BUT if given time, little or no prompting required.
200
You had an assessment visit with your member yesterday at 10am and created a UAS in the Health Commerce System at that time. When must your visit documents be attached to Sharepoint?
What is by COB the day following the assessment.
*For Friday assessments it is highly recommended that you finalize and attach documents by COB Friday.
200
Unless otherwise specified, UAS responses measure an individual’s objective performance and capacity in a variety of areas over the last how many days?
The UAS assessment is often described as a 3-day snapshot of the member's functional abilities and deficits.
200
How many times may we give the instructions to the member for the 3-step command which measures procedural memory?
One time only, so make sure to ask your member if you have their full attention before proceeding.
200
How would you code this member for lower body dressing?
Extensive assistance - Weight-bearing support by 1 helper where person still performs 50% or more of subtasks.
300
Your member requires the weight bearing assistance of one person to step into the tub due to her left lower leg fracture. The PCA bears the member's weight under the armpits and helps her sit on the shower chair. The aide then stands at the door to listen if the member needs help while she bathes. What is the best code selection for this member?
Independent, setup help only
Limited assistance
Extensive assistance
Maximal assistance
Extensive assistance - Weight-bearing support by 1 helper where person still performs 50% or more of subtasks.
Bathing - How takes bath or shower. Includes how transfers in and out of tub or shower AND how each part of body is bathed: arms, upper and lower legs, chest, abdomen, perineal area - EXCLUDE WASHING OF BACK AND HAIR.
300
If a member is self-directing and can contribute to the task of meal prep by asking the PCA to make his oatmeal and toast for breakfast by 9am, how would we code this member for meal prep?
Maximal Assistance.
300
True or False: For Friday assessments, it is highly recommended that Assessors sign and finalize their UAS assessments and attach all documents to Sharepoint by COB Friday.
TRUE.
300
According to your Required Comments Job Aide, what HIPAA precautions must Assessors take at assessment visits?
Assessors must document that the member granted permission for HIPAA protected information to be discussed in the presence of *anyone* else in the home prior to beginning the assessment and document the names of those granted permission. This includes, but is not limited to, family members, PCA, FCC, CDPAS. etc.
Common Audit error: Assessor did not document name(s) of those granted permission to be present for the duration of the assessment.
300
If we subtract points from the denominator to reflect non-cognitive deficits, where must we legibly document the reason why we did this?
300
How would you code this member for upper body dressing?
Limited assistance - Guided maneuvering of limbs, physical guidance without taking weight.
400
Your paraplegic member wants to comb his hair, wash his face, and shave. He wheels himself into the bathroom where the PCA places his comb, washcloth, and shaving kit within his reach. She then leaves him alone to go make his breakfast. What is the best code selection for this member for hygiene?
Independent, setup help only
Limited assistance
Extensive assistance
Maximal assistance
Independent, setup help only - Article or device provided or placed within reach, no physical assistance or supervision in any episode.
Personal hygiene - How manages personal hygiene, including combing hair, brushing teeth, shaving, applying make-up, washing and drying face and hands - EXCLUDE BATHS AND SHOWERS
400
What are the two main reasons a HF assessment nurse checks a member's Medicaid ID (or CIN#) in the Electronic Provider-Assisted Claim Entry System (ePaces) prior to scheduling a visit?
1. To validate Medicaid Eligibility
2. To ensure that the member is attached to a HealthFirst health plan.
400
Your UAS assessment may only remain unfinalized for how many days before it is auto locked by the Health Commerce System, requiring a re-assessment?
What is 5 days?
400
True or False: According to your job aide, you must use 3 identifiers (such as name, DOB, address) to positively identify your member.
True.
400
How many times may an assessor repeat the word list for the 3-word recall, which measures short term memory, before determining that the member will not be able to repeat them all?
6 Times.
Remember to provide the full list of words each time, not just the word/s the member could not repeat.
400
How would you code this member for ambulation?
Limited assistance - Guided maneuvering of limbs, physical guidance without taking weight.
500
It is the convention for coding Toilet Use because dressing is involved in both tasks.
We code at the same level as lower body dressing- or within one level down (toward less assistance) - because lower body dressing is required for both lower body dressing and toilet use.
500
What piece of member information does the Assessor need in order to check a member's eligibility status in ePaces?
What is the member's Medicaid ID?
This is also known as the member's CIN (customer information number).
500
True or False: Your required comments entries in the UAS comment boxes are strictly audited every month by the Healthfirst audit team.
TRUE.
Passing is a 90%, and the audit team looks at required comments, coding selections, UAS finalization time, when documents were attached to Sharepoint, how visit documents were filled out, etc. These are just a fraction of the items scrutinized by the Audit team monthly.
500
True or False: Blue questions marks in the UAS-NY assessment provide quick interventions for assessors.
False: The blue checkmarks in the UAS provide clarifying information about a particular question (or section) and its intent.
500
At one point in the MMSE, you are asked to point to a pencil and a watch and have the member name them as you point. What should you do if you do not have a watch or pencil handy?
Choose any other two familiar items, such as a cup or a spoon.
Do not choose IT gadgets pictured here such as Bluetooth earpieces or USB ports - many of our members will simply not be familiar with them.
500
How would you code this member for ambulation?
Extensive assistance - Weight-bearing support by 1 helper where person still performs 50% or more of subtasks.