Does GG affect Medicare reimbursement?
- Helper does MORE THAN HALF the effort. Helper lifts or holds trunk or limbs and provides more than half the effort. 01. Dependent - Helper does ALL of the effort. Patient/resident does none of the effort to complete the activity. Or, the assistance of 2 or more helpers is required for the patient/resident to complete the activity.
What is section GG in nursing?
The CMS definition of Qualified Clinician does allow for therapists to enter GG code information. Still, no CMS mandate or rule stipulates that therapists must be the clinician who does report RAI or MDS information. But the Centers for Medicare & Medicaid Services, Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual ...
Should section GG be completed on Medicare a PPS patients?
· A: The Impact Act mandated that the Centers for Medicare & Medicaid Services (CMS) establish a Quality Reporting System (QRP), wherein each skilled nursing facility (SNF) must submit data on quality measures. CMS created Section GG to capture the required quality measures for functional data reporting. Thus, the SNF is ultimately responsible ...
What is a GG code for nursing home?
MDS coding experts must remain vigilant! Beware coding pitfalls when it comes to Section G versus Section GG. Because Your Med A Revenue is at Stake One little letter can have a big impact on your Medicare Part A bottom line, because dramatic financial implications can exist for coding missteps when it comes to scoring Section GG. In a big way!
What is a GG code?
First, GG codes are a portion of the CMS, Resident Assessment Instrument, or RAI. According to the Centers for Medicare & Medicaid Services, Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual: Version 1.16.
What is Section GG on MDS?
SECTION GG: FUNCTIONAL ABILITIES AND GOALS Intent: This section includes items about functional abilities and goals. It includes items. focused on prior function, admission performance, discharge goals, and discharge performance.
What is the difference between Section G and Section GG?
Section G: The guidance is to code the most amount of assistance provided within a 7 day look-back. In Section GG: Guidelines are to code the baseline performance ability within the first three days following admission and before treatment begins.
What is GG in PDPM?
Under PDPM, Section GG will now be used to determine functional scores and will impact reimbursement through the case mix index weight. Section GG is going to be used to determine a separate ADL score for Nursing and Therapy, which will impact reimbursement under PDPM, as of 10/1/19.
What are GG items?
It means godly good. Barry wrote: Actually GG was used as a descriptor for items in Diablo 2. It means godly good.
When should GG tab be completed?
For an eval only that is completed at least 2 days after the facility admission, Rehab Optima will require an admission GG assessment and discharge GG assessment to be completed. For this situation enter dashes in all performance areas.
What is GG functional score?
Section GG scoring states that the higher the score, the more independent the resident is. Additionally in section GG, several items are combined to determine an average score.
Is section GG a standardized assessment?
Section GG is utilized across all post-acute care (PAC) settings by Medicare (CMS). While Section GG is a standardized assessment, other assessments can and should be utilized during a comprehensive occupational therapy evaluation.
What is the purpose of MDS and GG codes?
MDS and GG codes help CMS understand the functional abilities and progress of patients receiving post-acute care. Data must be entered into the MDS by Qualified Clinicians. Historically, the MDS nursing staff entered this data, and the training material and RAI manual provided by CMS continue to utilize language that continues to support this practice; however, the definition of Qualified Clinician could allow a therapist to be the designated person to enter this data.
How long is the CMS assessment period?
CMS anticipates that an interdisciplinary team of qualified clinicians is involved in assessing the resident during the three-day assessment period.
Who is responsible for completing Section GG?
Thus, the SNF is ultimately responsible for completing Section GG. However, due to the nature of the requirements, all core staff (including therapy) working with patients will be affected.
How many alpha scores does Section GG have?
Section GG has three numeric score options that can be used to classify the reasons for an activity not being attempted, whereas the CARE Item Set has four alpha scores. Section GG includes a slightly different set of items than are used in the CARE Item Set.
What is the QRP measure?
This requirement is met by documenting at least one discharge goal item on Section GG for at least one self care or mobility item. The discharge goal does not have to be created by therapy (in some cases, that would not be appropriate) and should be based on results of the initial Section GG assessment and collaboration with the care plan team.
Do you have to complete GG on Medicare?
A: Section GG must be completed on Medicare A PPS patients.
Is GG required by CMS?
A: No. Section GG is required by CMS but the CARE Item Set is not. Section GG does contain CARE items, which is why some therapy providers are choosing to require staff to complete the CARE Item Set as well.
What is Section G guidance?
Section G: The guidance is to code the most amount of assistance provided within a 7 day look-back.
Is feeding tube considered a section GG?
Guidelines instruct to score admission performance and discharge goal for “Eating” as: The ability to use suitable utensils, to bring food and/or liquid to the mouth, and swallow food and/or liquid once the meal is placed before a resident. Intake via feeding tube is not a consideration in Section GG, as it is in Section G.
What is Medicare Part A?
Medicare Part A is hospital insurance and provides coverage for inpatient stays at hospitals and skilled nursing care facilities, among other inpatient services.
What is the Medicare card number?
The number displayed on your Medicare card, however, is known as the Medicare Beneficiary Identifier and is randomly generated for you.
What is Medicare Supplement Insurance?
Medicare Supplement Insurance, also called Medigap, uses a letter system to identify its plans. Medicare Supplement Insurance is used in conjunction with Part A and Part B of Medicare to provide coverage for certain out-of-pocket expenses like some Medicare deductibles and coinsurance.
How many Medicare Supplement Plans are there?
There are 10 Medicare Supplement Plans to choose from, identified by letters: Plan A, B, C, D, F, G, K, L, M and N. Note that Medigap coverage options are referred to as “plan” (e.g., Medigap Plan A) as opposed to “part” (Medicare Part A hospital insurance).
How many characters are in a Medicare card?
The Medicare number displayed on Medicare cards (known as an MBI, or Medicare Beneficiary Identifier) is 11 characters long: The 2nd, 5th, 8th and 9th characters are always a letter, and the 3rd and 6th characters are sometimes a letter.
Does Medicare cover dental insurance?
Many Medicare Advantage plans may also cover additional benefits not covered by Part A and Part B, such as prescription drugs, dental, vision, hearing, wellness programs like SilverSneakers and more. Medicare Part D provides coverage exclusively for prescription drugs.
How long is GG required for?
GG will be required for each skilled admission (5-day), readmission 5-day, and with any planned discharge.
How long do you have to complete Section GG?
As long as resident stays at least two days in a skilled stay , then you will complete Section GG. If you look at the RAI page GG-9, it gives you some great examples of how to ask probing questions of your staff to get the answers you need to answer Section GG. Like I said in the webinar, it is probably a good idea to educate your staff on this new terminology so that you can get them familiar with the questions you might ask. This new section is going to require the MDSC to become comfortable with assessing the residents. There are no recommended forms for tracking this information. I’m sure someone will develop one, but at this time the assessment encourages direct observation, interview and assessment.
Does Medicare Part A apply to all Medicare Part A admissions?
Yes, this applies to all Medicare Part A admissions regardless of the location prior to admission. (Again, check with HMO/MCO regarding their preferences.)
Does GG affect RUG?
GG does not impact your RUG score for that assessment period. But it can impact your overall reimbursement when your rates are set for the next reimbursement cycle. They are stating that any failure to complete QM data items can reduce your overall reimbursement by 2%.