Unlike self-care (GG0100A), mobility (GG0100B) and stairs (GG0100C), transferring is not addressed in the ‘prior’ manner. That means you don’t have an automatic GG0170 discharge goal– unlike those for all the other GG0130 and GG170 items (except for wheelchair use). Without determining the patient’s prior transfer ability and unless the patient is independent, s/he is a candidate for physical therapy for transferring rehabilitation.

If the patient is independent in Transferring…

The patient is NOT a candidate for rehabilitation. The patient is independent if M1850 is answered with ‘0 - Able to independently transfer’ or ‘1 - Able to transfer with minimal human assistance or with use of an assistive device’. Unless there is no caregiver and the assignment of “1” is a lower level of functioning because of this illness, physical therapy isn’t indicated.

GG0170 Transfer items A, B, C, D, E and G should be answered ‘05 - Setup or clean-up assistance’ or ‘06 – Independent’ for both SOC Performance and Goal.  See Figure 1.

Figure 1. If the patient is independent in M1850 transferring, therapy is not indicated and an independent performance at SOC should be duplicated for discharge goal. 

If the patient requires transferring assistance…

The patient IS A CANDIDATE for physical therapy. The patient requires assistance if M1850 is answered with ‘2 - Able to bear weight and pivot during the transfer process but unable to transfer self.’

Since the patient is not bedbound, items A through C are not applicable and can be recorded as if the patient is independent. See Figure 2.

Items D, E and G should be answered 03. Partial/moderate assistance, or 04. Supervision or touching assistance for SOC Performance and 05 or 06 for the Discharge Goal.

Figure 2. If the patient requires assistance for M1850 transferring, therapy is indicated. GG0170A-C should be recorded as ‘independent’ while D, E and G support the answer to M1850.

If the patient is dependent in transferring…

The patient IS A CANDIDATE for physical therapy.  The patient is fully dependent if M1850 is answered with ‘3 - Unable to transfer self and is unable to bear weight or pivot when transferred by another person’.

Like above, since the patient is not bedbound items A through C are not applicable and can be recorded as if the patient is independent.

Items D, E and G should be answered 01 or 02 for SOC performance and 03 or 04 for the Discharge Goal. See figure 3.

Figure 3. If the M1850 transferring is a 3, GG0170A-C should be recorded as ‘independent’ while D, E and G are consistent with the answer to M1850.

If the patient is bedbound but can position her/himself in bed…

The patient IS NOT CANDIDATE for physical therapy.  If this is the case, then ‘4’ is the appropriate answer to M1850.  Answer 4 – “Bedfast, unable to transfer but is able to turn and position self in bed” stipulates that the patient is independent in bed mobility.  Hence rehabilitation is not indicated. In this case. The REVERSE occurs with A-C and D-G. Mark A, B and C as independent for both SOC performance and Discharge goal and D, E and G with ’09’ for both SOC and Goal.

• Roll left and right 05 or 06 both SOC and Discharge
• Sit to lying 05 or 06 both SOC and Discharge
• Lying to sitting on side of bed 05 or 06 both SOC and Discharge
• Sit to stand 09 both SOC and Discharge
• Chair/bed-to-chair transfer 09 both SOC and Discharge
• Car Transfer 09 both SOC and Discharge

If the patient is bed-bound and unable to position her/himself in bed…

The patient IS A CANDIDATE for physical therapy.  If this is the case, then ‘5’ is the appropriate answer to M1850.  Answer “5 - Bedfast, unable to transfer and is unable to turn and position self” stipulates that the patient is dependent in bed mobility.  Hence rehabilitation is indicated. In this case mark A, B and C as dependent for SOC performance and the Discharge goal one or two points higher. Mark D, E and G with ’09’ for both SOC and Goal.

• Roll left and right 01 or 02 for SOC and 03 or 04 Discharge
• Sit to lying 01 or 02 for SOC and 03 or 04 Discharge
• Lying to sitting on side of bed 01 or 02 for SOC and 03 or 04 Discharge
• Sit to stand 09 both SOC and Discharge
• Chair/bed-to-chair transfer 09 both SOC and Discharge
• Car Transfer 09 both SOC and Discharge

The patient is NOT a candidate for Physical Therapy when…

• prior functioning is the SAME as current functioning
• rehabilitation potential is low
• if the patient has suffered cognitive deterioration as the result if this illness and is unable to be taught rehabilitation techniques.

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