Posts tagged ‘Gait’

August 24, 2010

Confusion over case mix and 781.2? No.

Question: People were overusing 781.2, and then the criteria changed on how to capture case mix points: You also needed and ulcer and/or IV therapy. Is this still the criteria?

Lisa says: The criteria haven’t changed since January 2008.  Abnormality of gait is still case mix, but does not receive points unless the patient also has a pressure ulcer, it’s an early episode and there are less than 14 therapy visits. (See row 19 of CMS’s Table 4 for the official cite.)

Infusion therapy has never been part of the criteria for 781.2. Always remember that you code for medical necessity and services provided, NOT case mix.

May 6, 2010

A look at gait

Abnormality of gait is one of the most talked about, most misused, and abused code. In this post, I want to look at different types of gait, and which can be used with 781.2. This will show the importance of reading notes in the your manual to understand where to go to find your code.

First, let’s look at types of gait:

  • Ataxic: Unsteady or uncoordinated walk;
  • Paralytic: Loss of motor ability while walking;
  • Spastic: Legs held together and moving in a stiff manner;
  • Staggering: Swaying and loss, then recovery, of balance.

If you look in your code book, you see that 781.2 excludes ataxia …. (look up the codes listed to see where you should go for that!) and difficulty walking. Go elsewhere, if that’s what your patient has.

Always remember to look at your category for more instructions … Category 781 EXCLUDES disorders specifically related to: back, hearing, joint, limb, neck, vision, and pain in the limb. If these are the root of the problem, go to the codes indicated to find the correct code; do NOT use 781.2

Start with the exclusions, and you’ll be a better coder.