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Discussion

Section G (Range of motion)

Hello my fellow coordinators! I have a silly question because I was recently informed that my resident with a bka to both lower extremities should be coded as 0/0 for G0400. So now I am thrown off with this section. Please someone help me clarify how to code properly. Another resident with hemiplegia is now eating with her opposite hand and is able to conduct her daily activities. Would I still code 1 for her? I am over-thinking this now.

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Hello my fellow coordinators! I have a silly question because I was recently informed that my resident with a bka to both lower extremities should be coded as 0/0 for G0400.

According to the RAI G-31, "This item is coded in terms of function and risk of injury, not by diagnosis or lack of a limb or digit."

Do not look at limited ROM in isolation. You must determine if the limited ROM impacts functional ability or places the resident at risk for injury. For example, if the resident has an amputation it does not automatically mean that they are limited in function. He/she may not have a particular joint in which certain range of motion can be tested, however, it does not mean that the resident with an amputation has a limitation in completing activities of daily living, nor does it mean that the resident is automatically at risk of injury. There are many amputees who function extremely well and can complete all activities of daily living either with or without the use of prosthetics.

In which case, code 0

If the resident with an amputation does indeed have difficulty completing ADLs and is at risk for injury, the facility should code this item as appropriate.

Hence, code 2

Another resident with hemiplegia is now eating with her opposite hand and is able to conduct her daily activities. Would I still code 1 for her? I am over-thinking this now.

Yes. See G-31 last paragraph for the example for G400A.

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