Miscellaneous
Scoring on GG items range from 1-6. Can you name them?
ind, set up, sup/touch assist, partial/mod assist, sub/max assist, dependent
True or False
GG0170F toilet transfer includes client's ability to perform toilet hygiene and manage clothing
False
Toileting hygiene, clothing management, getting to and from the toilet, and transferring on/off a bedpan are not considered part of the toilet transfer activity.
At SOC you observe client ambulating with FWW around her ALF. She positions walker far forward and becomes unsteady intermittently especially with turns requiring stand by assistance to be safe. She doesn't fall or become unstable enough to require hands on assistance but you feel most comfortable being close to her to be safe. You instruct her to move walker closer to herself which she does and doesn't lose balance or become unsteady for the rest of the time she ambulates during visit.
What is the accurate code for M18060 ambulation?
3- able to walk only with supervision or assistance of another person at all times
When do you choose the ANA code 09?
when client did not perform activity prior to current illness,exacerbation, or injury
Client has MS affecting endurance and strength. Client prefers to feed self as much as possible. After eating three-forths of her meal by herself, she becomes fatigued and requests assistance from CNA who feed her the remainder of the meal.
How would you code GG0130A feeding?
3-partial/mod assistance
CNA provides less than half the effort to complete the activity of eating.
Client is chairfast/non-ambulatory. He is able to transfer with assistance. He states he is never short of breath. During assessment, you observe client stops talking frequently to catch breath.
How would you answer M1400 (when is client dyspneic or short of breath)
3- with minimal exertion
When would you choose physician specified SOC date M0102 vs referral date M0104?
M0102 physician specified answered yes when a "new specified SOC date" note is entered in chart.
If not, answer no and M0104 referral date is answered. Refer to "clinical comment intake note" or CCIN in coord notes for answer. If no CCIN, let office know.
Client requires a helper to lift her nightgown and pull down her underwear due to balance problems. After voiding, client wipes herself and pulls her underwear back up.
How would you coder her performance for toileting hygiene?
Code 03- partial/moderate assistance
At SOC, client is able to assist with pulling up pants/undergarments from knee level while seated, and can help in standing with clothing management up to waist level.
Assistance is required to initiate clothing over BLE and to stand and manage clothing from posterior aspect, including zipper/buttons. Unsteadiness is observed in unsupported standing, requiring physical assistance for safety.
How would you score M1820 Lower Body dressing?
2- Requires verbal cues, supervision, or physical assistance.
Name at least 3 questions used to risk adjust the DFS
age, admission function score, BMI, surgery, prior function, PI, cognitive function, oral med management, availability of assistance, admission source, All GG0130 and GG0170 answers at SOC, risk for hosp, comorbidities, prior device use, incontinence, confusion, supervision and safety sources of assistance
A helper provides verbal instruction to assist client in rolling onto R side. Due to LUE weakness, client needs physical assistance from helper to initiate rolling onto R side. Client returns to lying on back without assistance by using R arm to grasp bedrail.
How would you code performance in rolling right & left?
Code 03- partial/moderate assistance
Client returned home 2 days ago from the hospital. During SOC OASIS assessment, you ask how he has bathed since return from hospital. He says, "I have been too weak to even try to get in shower. I just wash up at sink." You enter bathroom with him and provide significant verbal cues and min assist for shower transfer. When observing routine, he requires verbal cues throughout task and supervision for safety when gathering items.
How would you code M18030 bathing?
5- unable to use shower or tub, but able to participate in bathing self in bed, at the sink, in chair or on commode, with assistance or supervision of another person throughout bath
**unsafe and required intervention of verbal cues and assistance prior to completing showering task therefore not appropriate for code 3 able to participate in bathing self or shower but requires person throughout bath for supervision or assist
Client has been on service and PCP is signing HH orders. Client has indwelling catheter and is following with urologist. New orders received for antispasmodic medication.
What are the steps required to add new order?
1. Send order to signing MD to say "Home agency may accept orders from xxxx." OR at SOC add the "additional physician" pathway
2. Write new order with new medication listing urologist as ordering provider. If verbal order, need to send to that doc and click verbal order. If transcribed from AVS, don't need to send to doc if AVS sent to securechat/attached to chart.
At SOC, you assess client who does not sleep in bed but in a recliner. Client needs helper to locate remote with verbal cues on which buttons to press to recline chair.
How would you code their sitting to lying?
4-Supervision or touching assistance
At discharge, how would you code M2020 oral med management on the following client?
Client resides at ALF where med techs administer medications. Client has cognitive impairment but is able to walk with RW and CGA. He is able to follow commands and cues to find way to nurses' station.
2- able to take medications at correct times if given reminders by another person at the appropriate times