COGNITION
Assessment Tool Mini-Mental State Exam (MMSE) Montreal Cognitive Assessment
ICF Level
Brief Description
Authors or Related Article/Access Folstein, Folstein, & McHugh (1975) http://www4.parinc.com/Products/Product. aspx?ProductID=MMSE-2
Body structure/ function
Brief screen measuring cognitive performance.
Body structure/ function
Brief screen for the detection of mild cognitive impairment. 10-item screening tool to detect presence and degree of intellectual impairment. Brief screen for detecting mild cognitive impairment and dementia.
Nasreddine, et al. (2005) http://www.mocatest.org/
Short Portable Mental Status Questionnaire (SPMSQ)
Body structure/ function
Pfeiffer (1975) http://www.npcrc.org/files/news/short_portable_mental_ health_questionnaire.pdf
St. Louis University Mental Status Exam (SLUMS)
Body structure/ function
Tariq, Tumosa, Chibnall, Perry, & Morley (2006) http://aging.slu.edu/pdfsurveys/mentalstatus.pdf
APPENDIX B: G-CODES
to which the patient’s life is affected. Two letters line up with the percentage of severity. The “C” modifier indicates the severity of the functional limitation, as illustrated in Table B-2. The therapist should use assessment tools or objective measures to determine the severity of the functional limitation. More than one tool may be used. Of course, the therapist’s judgment in combination with the data should also be used. Table B-2: Severity/Complexity Modifiers “C” Modifier Impairment Limitation Restriction CH 0% impaired, limited, or restricted. CI At least 1% but less than 20% impaired, limited, or restricted. CJ At least 20% but less than 40% impaired, limited, or restricted. CK At least 40% but less than 60% impaired, limited, or restricted. CL At least 60% but less than 80% impaired, limited, or restricted. CM At least 80% but less than 100% impaired, limited, or restricted. CN 100% impaired, limited, or restricted. Note . Adapted from “Quick Reference Chart: Descriptors of G-Codes and Modifiers for Therapy Functional Reporting,” by the Medicare Learning Network, 2015, retrieved from https://www.cms. gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNProducts/Downloads/G-Codes-Chart-908924.pdf Severity is affected by the level of activity and participation the patient experiences in daily life. The patient’s outcome measures are compared with those of people of the same age and gender, and with the same diagnosis and what comorbidities the patient has that affect function. The severity index is a reflection of all of the factors that are affecting this patient and causing the functional limitation. Outcome measures are therefore very important in assisting the physical therapist in determining the severity index. In fact, many outcome measures estimate a person’s percentage of disability based on the score obtained. The G-codes are updated at the tenth visit, or sooner if significant change or improvements are observed. If patients have a functional limitation that can be remediated, it is expected that that the level of severity will decrease by this tenth visit or sooner. Once the initially indicated functional limitation goal is achieved, that G-code is discharged. If the patient continues with physical therapy to address another
On July 1, 2013, the Centers for Medicare and Medicaid Services (CMS) made G-codes mandatory for billing. G-codes were developed to assist therapists in determining patients’ primary functional limitation at specified intervals. As reflected in the third column of Table B-1, the G-code is reported at three separate times under this schema. The physical therapist is required to determine the G-code for the client’s functional status during the initial evaluation, at or before the tenth visit, and at discharge. There are six categories of G-codes for physical therapy. Each category represents a type of functional limitation. Although the patient may have more than one functional limitation, the one with the greatest impact on function is selected for reporting. All reporting is done based on the goal derived from the functional limitation identified. Table B-1: Sample G-Codes Mobility G-Code Set Long Descriptor Short Descriptor G8978 Mobility: Walking and
Mobility current status.
moving around functional limitation, current status, at therapy episode outset and at reporting intervals. Mobility: Walking and moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting. Mobility: Walking and moving around functional limitation, discharge status, at discharge from therapy or to end reporting.
Mobility goal status.
G8979
G8980
Mobility discharge status.
Note . Adapted from “Quick Reference Chart: Descriptors of G-Codes and Modifiers for Therapy Functional Reporting,” by the Medicare Learning Network, 2015, retrieved from https://www.cms. gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNProducts/Downloads/G-Codes-Chart-908924.pdf During the initial examination, the physical therapist will select and report the G-code that most appropriately describes the patient’s primary functional limitation. The therapist will base this decision on the results of the evaluation and what the patient reports is affecting him the most. Next, the therapist will select a severity index to accompany the G-code. The severity index ranges from 0% to 100%. The physical therapist chooses this value based on the physical therapy examination and the extent
EliteLearning.com/Physical-Therapy
Page 54
Powered by FlippingBook