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. In addition, data for outcome improvement measures is being collected, as of 10/1/18, using Section GG for future use in quality measures that will take effect FY 2020. Therefore, SNF leaders must ensure that the person responsible for coding Section GG on the MDS is astute to the latest best practices.
Section GG Overview Section GG is a collection of data on Self-Care and Mobility items that measure a resident’s “usual performance” during the first three and last three days of a traditional Medicare A stay. This is captured on the 5-Day PPS assessment and End of Medicare Stay assessment.
The 5-Day PPS Assessment must have an ARD set on day 1-8 of the Medicare Part A stay. The lookback period for section GG is days 1-3 starting with the date in A2400B, Start of Most Recent Medicare Stay.
The Part A PPS Discharge Assessment is completed when a resident’s Medicare Part A stay ends. The lookback period for section GG is the last three days of the SNF PPS stay ending on A2400C.
The RAI Manual, Chapter 3 Section GG, is a good place to start to identify coding guidelines. Keep in mind: the Scoring Scale for Section GG: Self-Care and Mobility Items is different than the coding scale for Section G. The Section GG scoring scale under PDPM is: Tips for Scoring "Usual Performance"
The admission functional assessment, when possible, should be conducted prior to treatment interventions in order to determine a true baseline functional status on admission.