* Special Coding Corner Episode*- GG Items and Discharge Function Scoring

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In this episode, Stephanie and Tina cover the GG Items and Responses. It's also available as a Youtube presentation: https://youtu.be/ex7aDkCv3Os 

It is important to understand that the GG items and Discharge Function Scoring must be accurately calculated as this will have a significant impact on Value Based Purchasing. Agencies are Incentivized through VBP for the reimbursement of each patient. Reimbursement will be affected by a 5% increase or decrease in payment.

Some of the GOALS of VBP: -Reduce Hospitalization and use of Emergency Department -Reduce Spending -Increase Patient Mobility -Offer a more positive experience with Home-health The old measure of OUTCOMES will be replaced with a new Discharge Function Score. This score will be between 10-60. Previously, OUTCOMES were based on the M1800s (ADLs), M1400 (dyspnea), M2020 (oral med mgmt.), and M2420 (Discharge disposition). This score will now be based on: M1400 (dyspnea), M2020 (oral med mgmt.) AND: Mobility GG Items include Rolling, Lying, Transfer ability, and Ambulation. Functional GG Items – Eating, Oral Hygiene, and Toileting Hygiene. Keep in mind, dressing and grooming are no longer included. The score will now be a sum between 10 and 60. GG ITEM RESPONSE ITEMS 06 Independent – No assist needed at all 05 Set-up or clean-up assistance – No help needed during task completion 04 Supervision/Touching assistance – Verbal cueing, touching/steadying assistance, or supervision. Help may be throughout or intermittent. 03 Partial/Moderate assistance – Helper completes less than 50% of the effort 02 Substantial/Maximum assistance – Helper completes more than 50% of the effort 01 Dependent – when two helpers are needed, that equals DEPENDENT.

ANA (Activity not Attempted) IF USED in calculation, CMS will impute this data (best estimate of what the answer should be). Don’t give CMS the control, keep it with you!

07 Patient Refused – should not be used/rarely -needs additional documentation

09 Not Applicable “09 is baseline” No attempt during or prior to the assessment 10 Not attempted due to environmental limitations, ex. Lack of equipment and weather constraints

88 Not attempted due to medical condition or safety concern (current status but should be improved at D/C) “88 is current state” due to patient’s current medical condition.