Home Health & Hospice Week

Clear up this point of M1800 vs. GG item confusion.

Use the most recent OASIS-D guidance from Medicare to help staff sidestep one of the most common pitfalls they encounter with the new assessment tool.

Assessment staff naturally want to use their M1800 item experience to fill out the new GG items. But that can be a big mistake (see story, p. 34).

“The rule of the ‘majority’ of the tasks in an item applies to the M1800 items, but does not apply to the new items,” advises consultant Pam Warmack with Clinic Connections in Ruston, Louisiana.  “Additionally, some tasks in the M1800s are not a component of a similar new item,” Warmack adds.

The Centers for Medicare & Medicaid Services underscores the rule of majority difference in its January quarterly OASIS question-and-answer set.

Question: Does the “majority of tasks” convention apply to all Section GG items?

Answer: “The ‘majority of tasks’ convention that applies for the M1800 Activities of Daily Living (ADL)/Instrumental Activities of Daily Living (IADL) items does not apply to the GG Prior Functioning, Self-Care, and Mobility items,” CMS explains in the Q&As. “In situations where the patient’s prior ability varied between the listed GG activities, group all activities together and code based on patient’s ability considering all activities together. For example, for GG0100 Prior Functioning, if a patient completed all of the activities by him/herself, with or without an assistive device, with no assistance from a helper, code as ‘3. Independent.’

If a patient needed partial assistance from another person to complete any of the activities, code as ‘2. Needed Some Help.’ If a helper completed all of the activities for the patient because the patient could not assist, code as ‘1. Dependent.’ For the GG0130/GG0170 activities that include multiple activities (e.g., Upper body dressing for a patient who wears an undershirt, blouse, and sweater), code using the 6-point scale based on the patient’s ability to complete all relevant tasks” (emphasis added).

Note: The January Q&A set is at https://qtso.cms.gov/system/files/qtso/CMS_OAI_4th_Qtr_2018_QAs_Jan 2019_Final_508.pdf.