MDS Alert

Learn how to properly code for CPM device use.

O0500: Restorative Nursing Programs is not the easiest section of the MDS to code correctly. And if you’re making these kinds of mistakes, your compliance will go down the tubes, plus your reimbursement could take a plunge.

Don’t Get Creative with Your Math

Wrong way: You combine five minutes each of O0500A Range of Motion (Passive), O0500B Range of Motion (Active), and O0500C Splint or Brace Assistance to achieve 15 minutes total time in coding one day for each item.

Right way:For the seven-day look-back period, you should enter the number of days on which the technique, training or skill practice was performed for at least 15 minutes during the 24-hour period. This is true for each individual item, coded separately in time blocks of 15 minutes or more. You cannot add together minutes from different items to get 15 minutes.

But you can add together separate sessions of a single item provided at different times during the 24-hour period. For instance, you could code O0500A Range of Motion (Passive) if 10 minutes of this technique was provided on the day shift and 5 minutes on the evening shift.

No Double-Dipping for Therapy

Wrong way: The physical therapist provides 15 minutes of prostheses care to an amputee resident during a therapy session. You code this on O0500I Amputation/Prostheses care.

Right way: You cannot include in O0500 procedures or techniques provided by or under the direction of qualified therapists. Instead, you would code such therapies under O0400A Speech-Language Pathology and Audiology, O0400B Occupational Therapy, or O0400C Physical Therapy.

Don’t Include This for CPM Devices

Wrong way: You include 15 minutes of time when staff were applying and monitoring a continuous passive motion (CPM) device. You also include an additional 15 minutes of time while the resident was receiving treatment in the device.

Right way: You cannot include the time the resident spends receiving treatment in the CPM device — you can code only the time spent applying and monitoring the device.

Also, to code CPM use in a restorative nursing program, you must meet the following criteria:

1.  A physician must order it;

2.  Nursing staff must have received training in the technique (e.g., properly aligning the resident’s limb in the device, adjusting the available range of motion, etc.); and

3.  The staff must provide monitoring of the device.

Source: MDS 3.0 RAI Manual v1.09, Chapter 3, Section O.