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Distinct Calendar Days of Therapy
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Use this item when the facility is completing content tied to Section O and needs to stay anchored to v1.20.1.
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- Current source status: Published.
- Item locator: Manual page 55
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This page is grounded in CMS MDS 3.0 RAI Manual v1.20.1. Review the exact text and locators before treating the item as final reference content.
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Manual
CMS MDS 3.0 RAI Manual v1.20.1
Status
Published
Effective start
2025-10-01
Item locator
Manual page 55
CMS exact locator
Manual page 55
Full CMS Text
Chapter Section Page(s) version 1.20.1 Change O0420
Item Rationale
To record the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days.
Coding Instructions
Enter the number of calendar days that the resident received Speech-Language Pathology and Audiology Services, Occupational Therapy, or Physical Therapy for at least 15 minutes in the past 7 days. If a resident receives more than one therapy discipline on a given calendar day, this may only count for one calendar day for purposes of coding Item O0420. Consider the following examples: Example 1: Resident T received 60 minutes of physical therapy on Monday, Wednesday and Friday within the 7-day look-back period. Resident T also received 45 minutes of occupational therapy on Monday, Tuesday and Friday during the last 7 days. Given the therapy services received by Resident T during the 7-day look-back period, item O0420 would be coded as 4 because therapy services were provided for at least 15 minutes on 4 distinct calendar days during the 7-day look-back period (i.e., Monday, Tuesday, Wednesday, and Friday). Example 2: Resident F received 120 minutes of physical therapy on Monday, Wednesday and Friday within the 7-day look-back period. Resident F also received 90 minutes of occupational therapy on Monday, Wednesday and Friday during the last 7 days. Finally, Resident F received 60 minutes of speech-language pathology services on Monday and Friday during the 7-day look-back period. Given the therapy services received by Resident F during the 7- day look-back period, item O0420 would be coded as 3 because therapy services were provided for at least 15 minutes on 3 distinct calendar days during the 7-day look-back period (i.e., Monday, Wednesday, and Friday).
Chapter Section Page(s) version 1.20.1 Change O0425
Coding Instructions for Speech-Language
Pathology and Audiology Services and Occupational and Physical Therapies Individual minutes—Enter the total number of minutes of therapy that were provided on an individual basis during the entire Part A stay (i.e., from the date in A2400B through the date in A2400C). Enter 0 if none were provided. Individual services are provided by one therapist or assistant to one resident at a time. (For detailed definitions and examples of individual therapy, refer to O040390 above.) Concurrent minutes—Enter the total number of minutes of therapy that were provided on a concurrent basis during the entire Part A stay (i.e., from the date in A2400B through the date in A2400C). Enter 0 if none were provided. Concurrent therapy is defined as the treatment of 2 residents at the same time, when the residents are not performing the same or similar activities, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant for Medicare Part A. When a Part A resident receives therapy that meets this definition, it is defined as concurrent therapy for the Part A resident regardless of the payer source for the second resident. (For detailed definitions and examples of concurrent therapy, refer to item O040390 above.)
Chapter Section Page(s) version 1.20.1 Change O0425
Group minutes—Enter the total number of minutes of therapy that were provided in a group during the entire Part A stay (i.e., from the date in A2400B through the date in A2400C). Enter 0 if none were provided. Group therapy is defined for Part A as the treatment of two to six residents, regardless of payer source, who are performing the same or similar activities, and are supervised by a therapist or an assistant who is not supervising any other individuals. (For detailed definitions and examples of group therapy, refer to item O040390 above.) Co-treatment minutes—Enter the total number of minutes each discipline of therapy was administered to the resident in co-treatment sessions during the entire Part A stay (i.e., from the date in A2400B through the date in A2400C). Skip the item if none were provided. (For detailed definitions and examples of co-treatment, refer to item O040390 above.) O0425
Coding Tips and Special Populations
For detailed descriptions of how to code minutes of therapy and explanation of skilled versus nonskilled therapy services, co-treatment, therapy aides and students, please refer to these topic headings in the discussion of item O040390 above. O0425
Individual Therapy For a detailed definition and example of individual therapy, please refer to the discussion of item O040390 above.
Chapter Section Page(s) version 1.20.1 Change O0425
Concurrent Therapy For a detailed definition and example of concurrent therapy, please refer to the discussion of item O040390 above. Group Therapy For a detailed definition and example of group therapy, please refer to the discussion of item O040390 above. Therapy Modalities For a detailed definition and explanation of therapy modalities, please refer to the discussion of item O040390 above. O0425
A registered nurse or a licensed practical (vocational) nurse must supervise the activities in a restorative nursing program. Sometimes, under licensed nurse supervision, other staff and volunteers will be assigned to work with specific residents. Restorative nursing does not require a physician’s order. Nursing homes may elect to have licensed rehabilitation professionals perform repetitive exercises and other maintenance treatments or to supervise aides performing these maintenance services. In situations where such services do not actually require the involvement of a qualified therapist, the services may not be coded as therapy in item O0400, TherapiesO0390, Therapy Services, or O0425, Part A Therapies, because the specific interventions are considered restorative nursing services (see items O0400, TherapiesO0390, Therapy Services, and O0425, Part A Therapies). The therapist’s time actually providing the maintenance service can be included when counting restorative nursing minutes. Although therapists may participate, members of the nursing staff are still responsible for overall coordination and supervision of restorative nursing programs.
Chapter Section Page(s) version 1.20.1 Change O0425
Coding Instructions
This item does not include procedures or techniques carried out by or under the direction of qualified therapists, as identified in Speech-Language Pathology and Audiology Services item O040390A or O0425A, Occupational Therapy item O040390B or O0425B, and Physical Therapy item O040390C or O0425C.
Chapter Section Page(s) version 1.20.1 Change Hyperlinks in this section have been revised to reflect up-to- date locations.
Chapter Section Page(s) version 1.20.1 Change
The modification and inactivation processes are automated and neither completelydo not removes the prior erroneous record from iQIES. The erroneous record is archived in a history file. In certain cases, it is necessary to delete or change a record and not retain any information about the record in iQIES. This requires a request from the facility to the facility’s state agency to manually delete all traces of a record from the facility to complete an MDS 3.0 Individual Correction Request or MDS 3.0 Individual Deletion Request in iQIES. Additionally, in situations in which the state- assigned facility submission ID (FAC_ID) or state code (STATE_CD) is incorrect, an MDS 3.0 Manual Assessment Move Facility Request is required. The policy and procedures for a Manual Correction/Deletion Requestthese special requests are provided in Chapter 5 of this Manual.
A Manual Deletion Request isThese special requests are required only in the following four cases:
1. Item A0410 Submission Requirement is incorrect.
Submission of MDS assessment records to iQIES constitutes a release of private information and must conform to privacy laws. Only records required by the State and/or the Federal governments may be stored in the iQIES. If a record has been submitted with the incorrect Submission Requirement value in Item A0410, then that record must be manually deleted and, in some cases, a new record with a corrected A0410 value submittedthe facility must request correction of A0410 via an MDS 3.0 Individual Deletion Request or MDS 3.0 Individual Correction Request in iQIES. Item A0410 cannot be corrected by modification or inactivation. See Chapter 5 of this Manual and the iQIES Assessment Management: Assessment Submitter Manual for details.
Chapter Section Page(s) version 1.20.1 Change
2. Record was submitted for the wrong facilitywith
the incorrect state-assigned facility submission ID (FAC_ID) or state code (STATE_CD). If a record was submitted to iQIES for an incorrect facility or with an incorrect state code, the record must be removed manually and then a new record for the correct facility must be submitted to iQIESmanually corrected by the State Agency. Manual deletion of the record for the wrong facility is necessary to ensure that the resident is not associated with that facility and does not appear on reports to that facility. In these situations, the facility must complete an MDS 3.0 Manual Assessment Move Facility Request and send the request via certified mail to the State Agency.
3. Record submitted was not for OBRA or Medicare Part A purposes. When a facility erroneously submits
a record that was not for OBRA or Medicare Part A purposes, CMS does not have the authority to collect the data included in the record, and a manual deletion via an MDS 3.0 Individual Deletion Request in iQIES is required to remove it from the CMS database. For erroneous PPS assessments combined with OBRA- required assessments, if the item set code changes, the assessment must be manually deleted, and a new, stand-alone OBRA assessment must be submitted. If the item set code does not change, then a modification can be completed.
4. Inappropriate submission of a test record as a production record. Removal of a test record from iQIES requires manual deletionrecord deletion via an
MDS 3.0 Individual Deletion Request in iQIES. Otherwise, information for a “bogus” resident will be retained in the database and this resident will appear on some reports to the facility. X0310
Matrix Applicability
Matrix values will appear here after they are imported into the governed matrix tables.