Rule of three

  1. How would you all code this scenario:

    In the 7 day lookback period the resident's transfers are coded as such:

    1 time - limited assist
    1 time extensive assist
    8 times supervision
    4 times totally dependent

    If I were to code the most dependent that occurred 3 times, I should code totally dependent. But I can't because it didn't happen every time. So would you code Supervision, since that is the only other code that occurred 3 times and basically ignore the totally dependent codes?

    Or do you turn those totally dependent codes into extensive assist codes? (which I know we do when there are NO codes that are coded three times).

    Looking forward to hearing everyone's opinion.
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  2. 3 Comments

  3. by   Talino
    The following when factored:
    • 8 times supervision
    • 4 times totally dependent
    ... satisfy the instruction in p G-7
    c. When there is a combination of full staff performance/weight-bearing assistance, and/or non-weight-bearing assistance that total three or more times—code limited assistance (2).
  4. by   glm777
    But isn't that only if there are not three of any one code? In this case there are more than three instances of supervision.
  5. by   Talino
    If there are no three episodes (meaning each episode occured no more than 2x) at any given level, the code will be Supervision. Since there is 3 Total and 4 Supervision, the quoted rule applies.

    Better yet, set aside the instructions. Go directly to the algorithm. The decision will only terminate into one level - Limited Assistance.

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