(upbeat piano music)
- In this provider training video,
we will demonstrate how to assess item GG0170L.
Walking 10 feet on uneven surfaces,
using two different coding scenarios.
Remember, this item is coded
at both the admission and discharge.
Walking 10 on uneven surfaces is defined
as the ability to walk 10 feet on uneven
or sloping surfaces indoor or outdoor
such as turf or gravel.
Let's assess Ms. Carlson's admission performance
for walking 10 feet on uneven surfaces
to accurately code GG0170L.
Ms. Carlson has been newly admitted
and a nurse is completing the assessment
of the Section GG items.
The nurse explains to Ms. Carlson
the activity of walking 10 feet on an uneven surface.
You see Ms. Carlson attempting to walk on an uneven surface.
Ms. Carlson requires oxygen and the nurse assists
by carrying her oxygen concentrator.
Due to balance problems,
Ms. Carlson also requires a walker and a gait belt.
The nurse finds that Ms. Carlson
is having difficulty maneuvering the walker
over the uneven surface.
In addition, she starts having trouble
achieving enough foot clearance
to complete the forward swing of her right foot and leg.
The nurse assists by supporting Ms. Carlson's trunk
with the gait belt and bearing minimal weight
to help Ms. Carlson achieve the full forward swing
of her right foot and leg.
This assistance allows Ms. Carlson
to safely complete the 10 feet of distance.
How would you code Ms. Carlson's admission performance
for GG0170L. Walking 10 feet on uneven surfaces?
Code 06, Independent;
Code 05, Setup or clean-up assistance;
Code 04, Supervision or touching assistance;
Code 03, Partial/moderate assistance;
Code 02, Substantial/maximal assistance;
Or Code 01, Dependent.
The correct answer for Ms. Carlson's admission performance
for GG0170L. Walking 10 feet on uneven surfaces,
is Code 03, Partial/moderate assistance.
Partial/moderate assistance is defined
when a helper does less than half of the effort.
The helper lifts, holds or supports the patient's
or resident's trunk or limbs
but provides less than half the effort.
Ms. Carlson required the nurse to provide less
than half of the effort
in order to walk 10 feet on an uneven surface due
to weakness and shortness of breath.
As a result, you would code this item 03,
Partial/moderate assistance.
After admission, in many circumstances,
a patient or resident will receive nursing
and/or therapy services with the goal
of improving functional status.
An assessment of functional status related
to mobility is typically completed at discharge.
Now let's review a second coding example,
assessing Ms. Carlson's discharge performance
for walking 10 feet on an uneven surface,
in order to accurately code GG0170L.
Ms. Carlson is now ready for discharge
and the nurse is completing the assessment
of the Section GG items.
He explains to Ms. Carlson the activity
of walking 10 feet on an uneven surface.
You see Ms. Carlson using a walker
as she attempts to walk on an uneven surface.
Now that Ms. Carlson is stronger,
she can carry her oxygen in her walker basket
as she ambulates.
The nurse assists, standing by as Ms. Carlson walks
over the uneven surface.
At one point as she ambulates over the uneven surface,
Ms. Carlson stops to catch her breath
and momentarily rests.
The nurse checks in with Ms. Carlson
to ensure she is able to continue
and provides light touching assistance
as Ms. Carlson completes the activity.
How would you code Ms. Carlson's discharge performance
for GG0170L. Walking 10 feet on uneven surfaces?
Code 06, Independent;
Code 05, Setup or clean-up assistance;
Code 04, Supervision or touching assistance;
Code 03, Partial/moderate assistance;
Code 02, Substantial/maximal assistance;
or Code 01, Dependent.
The correct answer for Ms. Carlson's discharge performance
for GG0170L. Walking 10 feet on uneven surfaces,
is 04, Supervision or touching assistance.
Supervision or touching assistance
is defined as when the helper provides verbal cues
and/or touching, steadying and/or contact guard assistance
as the patient or resident completes the activity.
Assistance may be provided
throughout the activity or intermittently.
In this scenario,
the nurse assessed Ms. Carlson's discharge performance
for walking 10 feet on uneven surfaces.
The nurse had to provide supervision
and touching assistance
to enable the patient or resident to complete the activity.
Beyond this assistance,
no physical support or instruction
was provided by the nurse.
Due to the supervision needed to complete the activity,
GG0170L. Walking 10 feet on uneven surfaces,
would be coded 04, Supervision or touching assistance.
This video demonstrated coding for item GG0170L.
Walking 10 feet on uneven surfaces, based
on the type and amount of assistance provided
by a nurse to complete the activity.
The video captured a patient's or resident's performance
at admission and then at discharge.
In these scenarios,
Ms. Carlson demonstrated improved performance
in this mobility activity.
The first scenario demonstrated an example
of Code 03, Partial/moderate assistance.
The second scenario provided an example
of Code 04, Supervision or touching assistance.
We hope you found this video helpful.
For more information on coding Section GG,
refer to your settings specific guidance manual
which can be found on the CMS website.