Step-by-Step Coding Guide for GG0170I5: Walk 10 Feet (OBRA/Interim Performance)

1. Review of Medical Records

Objective: Assess the resident’s ability to walk 10 feet during the OBRA or interim assessment period.

Actions:

• Review the resident’s medical records, including physical therapy notes, nursing assessments, and mobility flow sheets.
• Observe the resident walking 10 feet to assess their mobility and need for assistance.

2. Understanding Definitions

GG0170I5: Walk 10 Feet: This item captures the resident’s ability to walk a distance of 10 feet during the assessment period. It includes any required assistance or assistive devices used.

Examples of Walking 10 Feet:

• Resident requires moderate assistance to walk 10 feet using a walker, with a helper providing guiding and steadying.
• A resident with Parkinson’s disease requires a therapist to advance their walker while walking 10 feet due to tremors​.

3. Coding Instructions

Step-by-Step:

• Step 1: Review the resident’s ability to walk 10 feet, either through observation or clinical records.
• Step 2: Assess if the resident needs assistance from a helper or an assistive device such as a walker or cane.
• Step 3: Choose the appropriate code based on the type and amount of assistance provided:
  • 06: Independent: Resident walks 10 feet without assistance.
  • 05: Setup or clean-up assistance: Resident requires assistance setting up but walks independently.
  • 04: Supervision or touching assistance: Helper provides only verbal cues or steadying.
  • 03: Partial/moderate assistance: Helper provides less than half of the effort required.
  • 02: Substantial/maximal assistance: Helper provides more than half of the effort required.
  • 01: Dependent: Two or more helpers are needed, or the helper performs all the effort​​.

Illustration 1:

• Scenario: Resident O has bilateral tremors and weakness. A therapist provides moderate steadying assistance while the resident walks 10 feet with a walker.
• Result: GG0170I5 is coded 03: Partial/moderate assistance.

4. Coding Tips

• Consider Assistive Devices: If the resident uses a walker, cane, or other assistive devices, this should not affect coding, but the amount of help provided by the helper will determine the appropriate code.
• Record Usual Performance: If the resident’s performance varies, record their usual ability during the assessment period, not their best or worst effort​.

5. Documentation

Objective: Ensure the resident’s ability to walk 10 feet and the type of assistance required is clearly documented.

Actions:

• Document the type and amount of assistance provided, as well as any mobility aids used (e.g., walker, cane).
• Ensure that the resident’s care plan includes their walking performance and any necessary interventions or safety measures​.

Illustration 2:

• Scenario: A resident uses a rolling walker and requires the therapist’s steadying support to walk 10 feet. They can walk independently for most of the distance but need support toward the end.
• Documentation: Document that the resident requires partial assistance and code GG0170I5 as 03: Partial/moderate assistance.

6. Common Errors to Avoid

• Misclassifying Assistance Levels: Ensure that the correct level of assistance is coded based on how much support the resident receives during the activity.
• Incomplete Documentation: Do not code GG0170I5 unless the resident’s ability to walk 10 feet is fully documented in the medical record.

Illustration 3:

• Scenario: A resident walks with a walker but needs substantial assistance from a helper for balance.
• Error: If coded as 03: Partial assistance, it would be incorrect. Code 02: Substantial/maximal assistance as the helper provides more than half the effort.

7. Practical Application

• Example 1: A resident walks 10 feet independently with no assistance. GG0170I5 is coded 06: Independent.
• Example 2: A resident with Parkinson’s disease requires a therapist to support and guide them while walking 10 feet with a walker. GG0170I5 is coded 03: Partial/moderate assistance.

Please note that the information provided in this guide for MDS 3.0 Item set GG0170I5 was originally based on the CMS's RAI Version 3.0 Manual, October 2023 edition. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0.  

The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding.  

Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.