CMS Issues RAI Manual Corrections

The Centers for Medicare & Medicaid Services (CMS) made several corrections to the October 1, 2013- RAI Manual, v. 1.11 related to therapy coding and the ADL function algorithm. Changes are found in the following sections:

  • The flowchart “ADL Self-Performance Algorithm,” which describes the algorithm for ADL function items in Chapter 3 Section G (page G-7), and the accompanying change table
  • Coding examples in Chapter 3 Section O (page O-33)
  • A change table page incorrectly transcribed from Chapter 3 Section O (page 3)

CMS has posted three files marked “(R)” for download as part of this errata release.  Two of these files are revised and one is a new, additional file. All three files include an “(R)” at the end of the file name.

Cil Bullard, RN, CPC, Virginia RAI/OASIS Coordinator, notified VHCA that she has received calls requesting clarification of the ADL coding as included in this October update. She suggests a review of the definitions of coding for each level of resident self-performance in Section G, page G-4, especially for coding Extensive Assist.  Providers must re-read all of Section G and work through examples as provided in the manual.  Continue to contact Cil with questions via email, which is preferred over phone messages, and if possible include a specific example in your email.