by Megan Bernier, MSPT RAC-CT COS-C
With the Discharge Function Score quality measure being added to Care Compare in January 2025 and in the HHVBP CY 2025 Performance Year applicable measure set, it’s more important then ever to understand the accurate coding of the GG items used in the calculation of the measure.
This blog is Part 3 of a 3-part series on the Discharge Function Score Quality Measure.
- Part 1 – GG Items and Measure Overview
- Part 2 – GG Assessment Strategies
- Part 3 – How Activity Not Attempted Codes and Assistive Devices Impact Coding GG Items
You might be surprised to find out that not all GG0130 Self-Care and GG0170 Mobility activities are used in the calculation of the Discharge Function Score (DFS) measure. The activities that are used are as follows:
- GG0130A – Eating
- GG0130B – Oral hygiene
- GG0130C – Toileting Hygiene
- GG0170A – Roll Left and Right
- GG0170C – Lying to Sitting on Side of bed
- GG0170D – Sit to Stand
- GG0170E – Chair/Bed-to-Chair Transfer
- GG0170F – Toilet Transfer
- GG0170I – Walk 10 feet
- GG0170J – Walk 50 Feet with 2 Turns
- GG0170R – Wheel 50 Feet with 2 Turns*
Understanding the guidance to accurately code these activities will also impact the measure results for DFS. Remember that when it comes to the DFS, the intent of the measure is to calculate the percentage of home health patients who achieve or exceed a risk adjusted expected function score at discharge.
Expected and Observed Values
To calculate the measure, CMS first calculates the expected discharge score, based on start of care (SOC)/resumption of care (ROC) GG codes and risk factors. CMS then compares this expected discharge score to the observed (actual) discharge score. This results in the measure results. When the observed (actual) score at discharge is the same or better than the expected score (calculated from SOC/ROC data), this is a favorable outcome. Higher results on this measure are better.
To calculate both the expected and observed scores, CMS uses a statistical method of imputation, basically meaning if any of the “activity not attempted” codes are used at SOC/ROC or discharge they will determine what the 06-01 performance score should have been.
In order to most accurately determine the patient’s functional status, it’s important that we use all the available CSM-approved guidance to help determine the most appropriate code for each activity. While each activity has guidance specific to that activity, there is also overarching guidance used for all the GG activities.
When assessing and coding GG activities allow the patient to perform the activity as independently as possible, as long as they are safe. And remember we use the “day of assessment” convention when determining the patient’s status.
Coming soon! The OASIS Answers blog: Discharge Function Score Quality Measure: Part 2 – GG Function Item Assessment Strategies
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