Step-by-Step Coding Guide for Item Set O0500A: Range of Motion (Passive): Number of Days

1. Review of Medical Records

• Conduct a thorough examination of the resident's medical and therapy records.
• Identify instances of passive range of motion (ROM) exercises provided to the resident during the 7-day look-back period, noting the dates of service.

2. Understanding Definitions

• Passive Range of Motion (ROM) Exercises: Movements applied to a joint by another person or by a mechanical device to maintain or increase the range of motion, without the resident's active participation.

3. Coding Instructions

• Count and record the number of distinct calendar days during the look-back period on which the resident received passive ROM exercises.
• Each day should be counted once, regardless of the number of sessions or joints exercised that day.

4. Coding Tips

• Ensure accurate differentiation between passive and active ROM exercises; only passive ROM exercises should be counted for O0500A.
• Review therapy schedules, nursing notes, and activity logs to verify the days passive ROM exercises were provided.

5. Documentation

• Document each session of passive ROM exercises provided, including the date, joints exercised, and the duration of each session.
• Note any observations regarding the resident's response to the exercises and any changes in joint mobility or discomfort.

6. Common Errors to Avoid

• Misclassifying active ROM exercises as passive ROM exercises.
• Overlooking passive ROM exercises provided by nursing staff in addition to therapy staff.
• Failing to document each day passive ROM exercises are provided, leading to underreporting.

7. Practical Application

• Example: A resident with post-stroke hemiplegia receives passive ROM exercises to the affected arm and leg on Monday, Wednesday, and Friday. Each day is documented, with a brief description of the exercises performed and the resident's tolerance, resulting in a total of 3 days reported for O0500A.

Please note that the information provided in this guide for MDS 3.0 Item set O0500A 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.