Section GG Stair Items: When "Not Attempted" Is an Equipment Decision
Short answer: Section GG has three stair items: GG0170M 1 step (curb), GG0170N 4 steps and GG0170O 12 steps. If the curb item is coded "not attempted" at admission, the form skips the rest of the stair sequence. One of the four "not attempted" codes, code 10, covers environmental limitations, and CMS's own example is "lack of equipment". That makes the stair items the place in Section GG where a facility's gym, and not only the patient, can decide what gets recorded. [1]
Key takeaways for rehab leaders
There are three stair items, each scored 01–06 or given an activity-not-attempted code (07, 09, 10 or 88). [1]
Coding 07, 09, 10 or 88 on 1 step (curb) or 4 steps at admission skips the remaining stair items. [1]
CMS sets no required step height; 1 step (curb) can be assessed on a curb or a step, with or without railings. [2]
The IRF motor score used for case-mix groups includes the curb item. [3]
Stair items are not part of the cross-setting Discharge Function Score. Their value is accurate function data and discharge planning, not quality-measure points. [5]
What are the Section GG stair items?
Section GG is the standardized functional assessment CMS uses across post-acute care: inpatient rehabilitation facilities (IRF-PAI), skilled nursing facilities (MDS 3.0), home health (OASIS) and long-term care hospitals. The mobility item GG0170 includes three stair activities. [1][6]
Item | CMS definition | If not attempted at admission |
GG0170M 1 step (curb) | "The ability to go up and down a curb and/or up and down one step." | Coded 07, 09, 10 or 88: skip to GG0170P, Picking up object |
GG0170N 4 steps | "The ability to go up and down four steps with or without a rail." | Coded 07, 09, 10 or 88: skip to GG0170P, Picking up object |
GG0170O 12 steps | "The ability to go up and down 12 steps with or without a rail." | Last item in the stair sequence |
Each activity the patient performs is scored on six levels, from 06 Independent to 01 Dependent. When an activity is not attempted, one of four codes is used instead: [1]
Code | Meaning |
07 | Patient or resident refused |
09 | Not applicable: not attempted, and the patient did not perform this activity before the current illness, exacerbation or injury |
10 | Not attempted due to environmental limitations (e.g., lack of equipment, weather constraints) |
88 | Not attempted due to medical condition or safety concerns |
The stair gap: one code can erase the whole sequence
Because of the skip pattern, the stair items behave like a chain. If 1 step (curb) is not attempted at admission, 4 steps and 12 steps are never reached. For a patient who will go home to a front porch or a second-floor bedroom, the admission record then holds no stair information at all.
Codes 07, 09 and 88 describe the patient: a refusal, no prior stair use, or a medical or safety reason. Code 10 is different. It describes the environment. When a stair item is coded 10 because there were no suitable steps to use, the missing data point says more about the rehab gym than about the patient.
That is the perspective of this article: for rehab leaders, the rate of code 10 on stair items is an equipment metric. It is a Section GG number that a director can change with a facility decision rather than by waiting for patient progress.
Why stair items matter, even though they are not in every measure
It is worth being precise about where stair items count. CMS's cross-setting Discharge Function Score uses ten Section GG items, none of which are stair items, and missing values in that measure are statistically imputed. [5] Stairs are not a lever for that quality measure.
They do matter in three other places:
IRF case-mix classification. The motor score CMS adopted for IRF case-mix groups from FY2020 includes GG0170M1, one step (curb), at admission. [3] In CMS's supporting analysis, items coded "not attempted" were recoded to 1 (Dependent) for that score. [4] Accurate curb assessment therefore shapes how the patient's function is represented.
Discharge planning. Entrance steps and indoor stairs often stand between a patient and home. CMS training guidance is direct: assess the patient going up and down 12 steps if safe to do so, because "the patient may encounter stairs in the community after discharge." [2]
Goals and continuity of care. Section GG goals and discharge scores follow the patient to the next setting, including home health and outpatient therapy. A record that shows stairs as "not attempted" gives the next team less to build on.
What CMS does and does not require for stair assessment
Facilities sometimes assume they need a full hospital stairwell to assess these items. CMS training Q&As are more flexible: [2]
1 step (curb) can be assessed using a curb or a step, with or without railings (Q72).
There are no specifications for the exact height of the steps (Q73).
If a patient is assessed on 12 steps, the clinician may be able to score 1 step and 4 steps from the same observation (Q61, Q78).
Getting to and from the stairs is not part of the activity, and the activity may be completed with or without a device or railing. [8]
Some RAI training resources also state that when 12 steps are not available, a clinician may use four stairs up and down three times consecutively. [8] Confirm this against the current CMS manual for your setting before building a protocol around it.
This article is educational and is not coding advice. Always code from the current RAI Manual, IRF-PAI Manual or OASIS Guidance Manual that applies to your setting.
A stair-readiness audit for rehab leaders
Five questions to put to your team this quarter:
What share of admission stair items (GG0170M, N and O) were coded 10 in the last six months, and why?
Can every therapy space offer one step, four steps and a safe way to reach 12 steps?
Can step height be matched to the patient's home entrance, or is there only one fixed height?
Are rails available on both sides, with room for a therapist to guard the patient?
How are stair conditions (step height, number of steps, rails, assistance and time) recorded between formal Section GG assessment points?
If the answer to the first question is higher than expected, the fix is usually not a new form. It is a practical, safe place to assess and practice stairs.
Where DPE Medical's adjustable training stairs fit
DPE Medical builds stair-and-gait stations for exactly this gap. The DST8000 Triple combines a height-adjustable staircase, an angle-adjustable slope and parallel bars in one unit, and therapists can change stair height and slope at the click of a button without changing equipment. [7]
The DST8000 Triple Pro records stair height and time, slope angle and time, and walking time across the parallel bars. The DST Triple Sense adds force-sensing gait data, including right/left and anterior/posterior force distribution, center of pressure, step length and step time, with real-time visual and auditory biofeedback and exportable treatment reports. [7]
Section GG need | How an adjustable stair station supports it |
1 step (curb) and 4 steps | Stairs on site remove "lack of equipment" as a reason to code 10 |
Matching the patient's home | Step height can be adjusted toward the patient's entrance steps |
Progress toward 12 steps | Repeated, recorded stair practice between formal assessment points |
Patient and therapist safety | Stairs, slope and parallel bars in one guarded station |
Data-driven rehabilitation | Stair height and time per session; gait and force data on the Triple Sense |
Two limits matter. First, the equipment does not produce a Section GG score; a trained clinician codes each item under the CMS manual. Second, practice data are not outcome evidence, and an equipment feature is not proof of better scores. What the equipment can do is remove the environmental barrier and give therapists consistent, documented stair practice.
For outpatient physiotherapy clinics
Outpatient clinics do not submit Section GG, but many of their patients arrive from inpatient rehab, skilled nursing or home health with Section GG discharge data. A clinic that can assess and train curbs and stairs in a measured, adjustable way can continue where the post-acute record left off, and can speak to referral partners in the same functional language.
Free tool: track Section GG walking and stair items
Record GG0170I–O at each timepoint, see which stair items were not attempted (and how often code 10 was used), and print a progress report. Patients are identified only by an anonymous code, and your data is visible only to your account.
Frequently asked questions
What are the Section GG stair items?
GG0170M 1 step (curb), GG0170N 4 steps and GG0170O 12 steps. Each is scored from 01 Dependent to 06 Independent, or given an activity-not-attempted code. [1]
What does code 10 mean in Section GG?
Not attempted due to environmental limitations, for example lack of equipment or weather constraints. [1]
What happens if 1 step (curb) is coded not attempted?
If admission performance is coded 07, 09, 10 or 88, the assessment skips to GG0170P, Picking up object, so 4 steps and 12 steps are not scored. [1]
Is there a required step height for Section GG?
No. CMS training guidance states there are no specifications for the exact step height, and 1 step (curb) may be assessed on a curb or a step, with or without railings. [2]
Are stair items part of the Discharge Function Score?
No. The Discharge Function Score uses ten Section GG items, none of which are stair items. [5]
Can a stair training device score Section GG?
No. Devices such as the DST8000 Triple Pro record practice conditions like stair height and time, but Section GG items must be coded by a clinician under the CMS manual for your setting.
Reviewing your stair and gait area? Contact DPE Medical to discuss an adjustable stair-and-gait station for your team.
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