functional limitation, a new G-code is assigned. Once the patient’s functional limitations have been remediated, he or she is discharged.
In summary, G-codes are required in the initial evaluation, reassessment, and discharge notes. Regular daily progress notes do not require G-codes. It is important for physical therapists to document the G-codes in the medical record, along with their rationale for determining severity. ● American Counseling Association http://www.counseling.org ● American Psychiatric Association http://www.psych.org ● Depression and Bipolar Support Alliance http://www.dbsalliance.org ● International Foundation for Research and Education on Depression http://www.depression.org ● National Institute of Mental Health http://nimh.nih.gov Information Resource Center: 866-615-6464 Organizations ● Academy of Geriatric Physical Therapy http://www.geriatricspt.org ● Administration for Community Living (ACL) https://www.acl.gov/ ● Eldercare Locator: 800-677-1116 https://eldercare.acl.gov/Public/Index.aspx ● Alzheimer’s Association http://www.alz.org ● American Physical Therapy Association http://www.apta.org ● National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov ● National Institute on Aging http://www.nia.nih.gov Buckinx, F., Reginster, J. Y., Brunois, T., Lenaerts, C., Beaudart, C., Croisier, J. L., …Bruyere, O. (2017). Prevalence of sarcopenia in a population of nursing home residents according to their frailty status: Results of the SENIOR cohort. Journal of Musculoskeletal and Neuronal Interactions, 17 (3): 209-217. Cahoon, C. G. (2012). Depression in older adults. American Journal of Nursing, 112 (11), 22-30. Campbell, A., & Buchner, D. (1997). Unstable disability and the fluctuations of frailty. Age and Ageing, 26 (4), 315-318. Carlo, A. P., Cavallotti, M., & Cerulli, L. (2008). Age-related changes of the human eye. Totowa, NJ: Humana Press. Cattell, R. B. (1963). The theory of fluid and crystallized intelligence: A critical experiment. Journal of Educational Psychology, 54 (1), 1-22. Centers for Disease Control and Prevention. (2009). P ercent of U.S. adults 55 and over with chronic conditions. Retrieved from http://www.cdc.gov/nchs/health_policy/adult_chronic_ conditions. Centers for Disease Control and Prevention. (2010). Preventing suicide . Retrieved from http://www.cdc.gov/violenceprevention/pdf/preventingsuicide-a.pdf. Centers for Disease Control and Prevention. (2011). Healthy aging: Helping people to live long and productive lives and enjoy a good quality of life . Retrieved from http://stacks.cdc. gov/view/cdc/6114/. Centers for Disease Control and Prevention. (2012). Depression is not a normal part of growing older. Retrieved from http://www.cdc.gov/aging/mentalhealth/depression.htm. Centers for Disease Control and Prevention. (2016). National suicide statistics at a glance. Retrieved from https://www.cdc.gov/violenceprevention/suicide/statistics/index.html. Ceria-Ulep, C. D., Grove, J., Chen, R., Masaki, K. H., Rodriguez, B. L., Donlon, T. A., … Curb, J. D. (2010). Physical aspects of healthy aging: Assessments of three measures of balance for studies in middle-aged and older adults. Current Gerontology and Geriatrics Research, Article ID 849761. doi:10.1155/2010/849761. Chang, J. T., & Ganz, D. A. (2007). Quality indicators for falls and mobility problems in vulnerable elders. Journal of the American Geriatrics Society, 55 (S2), S327-S334. Clemson, L., Mackenzie, L., Ballinger, C., Close, J. C. T., & Cumming, R. G. (2008). Environmental interventions to prevent falls in community-dwelling older people: A meta- analysis of randomized trials. J ournal of Aging & Health, 20 (8), 954-971. Clemson, L., Singh, M. F., Bundy, A., Cumming, R. G., Weissel, E., Munro, J., … Black, D. (2010). LIFE pilot study: A randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Australian Occupational Therapy Journal, 57 (1), 42-50. Cleveland Clinic. (2013). COPD. Retrieved from http://my.clevelandclinic.org/disorders/ chronic_obstructive_pulmonary_disease_copd/pul_overview.aspx. Colasanti, V., Marianetti, M., Micacchi, F., Amabile, G. A., & Mina, C. (2010). Tests for the evaluation of depression in the elderly: A systematic review. Archives of Gerontology and Geriatrics, 50 (2), 227-230. Cole, M. (2008). Theories of aging. In S. Coppola, S. Elliot, & P. Toto (Eds.), Strategies to advance gerontology excellence (pp. 135-162). Bethesda, MD: AOTA Press. Collard, R. M., Boter, H., Schoevers, R. A., & Voshaar, R. C. (2012). Prevalence of frailty in community-dwelling older persons: A systematic review. Journal of the American Geriatrics Society, 60 (8), 1487-1492. Cree, M., Soskolne, C. L., Belseck, E., Hornig, J., McElhaney, J. E., Brant, R., … Suarez- Almazor, M. (2000). Mortality and institutionalization following hip fracture. Journal of the American Geriatrics Society, 48 (3), 283-288. Cruz-Jentoft, A. J. , Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., … Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in older people. Age Ageing, 39 (4), 412-423. Dal Bello-Haas, V. (2009). Neuromusculo-skeletal and movement function. In B. Bonder & V. Dal Bello-Haas (Eds.), Functional performance in older adults (pp. 130-176). Philadelphia, PA: F. A. Davis. Daniels, R., van Rossum, E., de Witte, L., Kempen, G., & van der Herwel, W. (2008). Interventions to prevent disability in frail community-dwelling elderly: A systematic review. BMC Health Services Research, 8 , 278. Deary, I. J., Corley, J., Gow, A. J., Harris, S. E., Houlihan, L. M., Marioni, R. E., … Starr, J. M. (2009). Age-associated cognitive decline. British Medical Bulletin, 92 (1), 135-152. De Brito, L. B. B., Ricardo, D. R., de Anaujo, D. S. M., Ramos, P. S., Myers, J., & de Araujo, C. G. S. (2012). Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology, 21 (7), 892-898. De Smet, L. (2008). The DASH questionnaire and score in the evaluation of hand and wrist disorders. Acta Orthopaedica Belgica, 74, 575-581. Dite, W., & Temple, V. A. (2002). A clinical test of stepping and change of direction to identify multiple falling older adults. Archives of Physical Medicine and Rehabilitation, 83 (11), 1566-1571.
Resources Assessment Resources (Also see Appendix A) ● Borg Rate of Perceived Exertion Scale http://www.cdc.gov/physicalactivity/everyone/measuring/ exertion.html ● Geriatric Examination Tool Kit https://geriatrictoolkit.missouri.edu/ ● PTNow http://www.ptnow.org/FunctionalLimitationReporting/ TestsMeasures/Default.aspx http://www.ptnow.org/ClinicalTools/Tests.aspx ● Rehabilitation Measures Database https://www.sralab.org/rehabilitation-measures Exercise Programs ● National Council on Aging (Falls Prevention Programs) https://www.ncoa.org/healthy-aging/falls-prevention/falls- ● https://www.cms.gov/Outreach-and-Education/Medicare- Learning-Network-MLN/MLNProducts/Downloads/G-Codes- Chart-908924.pdf Mental Health Organizations ● American Association for Geriatric Psychiatry http://www.aagponline.org Administration on Aging. (2013). Aging statistics: A profile of older Americans: 2013 . Retrieved from https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20 America/2013_Profile.pdf. Administration on Aging. (2014). A profile of older Americans: 2014. Retrieved from https:// acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2014-Profile.pdf. Administration on Aging. (2015). A toolkit for serving diverse communities. Retrieved from https://www.aarp.org/content/dam/aarp/livable-communities/learn/demographics/Toolkit- for-Serving-Diverse-Communities-AARP.pdf. Administration on Aging. (2017). A profile of older Americans: 2017. Retrieved from https:// www.acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2017OlderA mericansProfile.pdf. prevention-programs-for-older-adults/ ● Otago Exercise Program information http://www.aheconnect.com/newahec/cdetail. asp?courseid=cgec3 G-Code Instruction References Agency for Healthcare Research and Quality. (2012). National healthcare disparities report. Retrieved from http://archive.ahrq.gov/research/findings/nhqrdr/nhdr12/index.html. Agency for Healthcare Research and Quality. (2014). National healthcare quality & disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhqdr14/ index.html. Albert, M. S., DeKosky, S. T., Dickson, D., Feldman, H. H., Fox, N. C., Holtzman, D. M., … Phelps, C. H. (2011). The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s and Dementia, 7 (3), 270-279. Alzheimer’s Association (2013a). Alzheimer’s disease. Retrieved from http://alz.org/ alzheimers_disease_alzheimers_disease.asp. Alzheimer’s Association. (2013b). Stages of Alzheimer’s. Retrieved from http://www.alz.org/ alzheimers_disease_stages_of_alzheimers.asp. Alzheimer’s Society. (n.d.). What is vascular dementia? Retrieved from http://www. alzheimers.org.uk/site/scripts/documents_info.php?documentID=161. American College of Sports Medicine, Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone Singh, M. A., Minson, C. T., Nigg, C. R., … Skinner, J. S. (2009). American College of Sports Medicine position stand: Exercise and physical activity for older adults. Medicine and Science in Sports & Exercise, 41 (7), 1510-1530. American Physical Therapy Association. (2008). 2008 Annual report (p. 5). Retrieved from http://www.apta.org/uploadedFiles/APTAorg/About_Us/Annual_Reports/ AnnualReport_2008.pdf. American Physical Therapy Association. (2015). Advocacy . Retrieved from http://www.apta. org/advocacy/ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. American Psychological Association. (2015). Cultural diversity and caregiving . Retrieved from http://www.apa.org/pi/about/publications/caregivers/faq/cultural-diversity.aspx. Anke, A.G. & Fugl-Meyer, A.R. (2003). Life satisfaction several years after severe multiple trauma—a retrospective investigation. Clinical Rehabilitation, 17 (4), 431-42. Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996). Comparison of Beck depression inventories-IA and II in psychiatric outpatients. Journal of Personality Assessment, 67 (3), 588-597. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4 (6), 561-571. Berg, K., Wood-Dauphinee, S. (1992). Measuring balance in the elderly: validation of an instrument. Canadian Journal of Public Health, 83 , Suppl 2, S7-11. Berger, M. J., & Doherty, T. J. (2010). Sarcopenia: Prevalence, mechanisms, and functional consequences. International Topics in Gerontology, 37 , 94-114. Berlau, D. J., Corrada, M. M., Pelz, C. B., & Kawas, C. H. (2012). Disability in the oldest-old: Incidence and risk factors in the 90+ study. American Journal of Geriatric Psychiatry, 2 0(2), 159-168. Berry, S., & Kiel, D. (2014). Treating hypertension in the elderly: Should the risk of falls be part of the evaluation? Journal of the American Medical Association Internal Medicine, 174 (4), 596-597. Blay, S. L., & Marinho, V. (2012). Anxiety disorders in old age. Current Opinion in Psychiatry, 25 (6), 462-467. Blennerhassett, J. M., & Jayalath, V. M. (2008). The Four Square Step Test is a feasible and valid clinical test of dynamic standing balance for use in ambulant people poststroke. Archives of Physical Medicine and Rehabilitation, 89 (11), 2156-2161. Bohannon, R. (2009). Measurement of gait speed of older adults is feasible and informative in a home-care setting. Journal of Geriatric Physical Therapy, 32 (1), 22-23. Bohannon, R. W. (1997). Comfortable and maximum walking speed of adults aged 20-79 years: Reference values and determinants. Age and Ageing, 26 (1), 15-19. Bonder, B. R. (2001). Growing old in the United States. In B. Bonder & M. B. Wagner (Eds.), Functional Performance in Older Adults (pp. 7-27). Philadelphia, PA: F. A. Davis. Bonder, B. R. (2009). Culture and aging. In B. Bonder & V. Dal Bello-Haas (Eds.), Functional performance in older adults (pp. 571-590). Philadelphia, PA: F. A. Davis. Borg, G. Perceived exertion as an indicator of somatic stress. (1970). Scandinavian Journal of Rehabilitation Medicine, 2 (2), 92-98.
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