Billing for Therapy Functional Reporting Therapy G Codes PT OT SLP
Jan10

Billing for Therapy Functional Reporting Therapy G Codes PT OT SLP

We saw this change Effective January 1, 2013 – The Therapy Functional Reporting Therapy G Codes The Policy: Therapy Functional Reporting Therapy G Codes   WHY the Change?   Section 3005(g) of MCTRJCA says, “The Secretary of Health and Human Services shall implement, beginning on January 1, 2013, a claims-based data collection strategy that is designed to assist in reforming the Medicare payment system for outpatient therapy services subject to the limitations of section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)). Such strategy shall be designed to provide for the collection of data on patient function during the course of therapy services in order to better understand patient condition and outcomes. This claims-based data collection system is being implemented to include both the reporting of data by therapy providers and practitioners furnishing therapy services and the collection of data by the contractors. This reporting and collection system requires selected claims for therapy services to include nonpayable G-codes and related modifiers. These nonpayable G-codes and severity/complexity modifiers provide information about the beneficiary’s functional status at the outset of the therapy episode of care, at specified points during treatment, and at the time of discharge. These G-codes and related modifiers are required on selected claims for all outpatient therapy services – not just those over the therapy caps. Source: CR-8005 Claims-Based Data Collection Requirement for Outpatient Therapy The Therapy Functional Reporting Therapy G Codes for CY 2013 and the Severity/Complexity Modifiers   Mobility: Walking & Moving Around   Therapy Functional Reporting G Codes are: G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting G8980 Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reporting Determine the Appropriate severity/complexity modifier: CH 0 percent impaired, limited or restricted CI At least 1 percent but less than 20 percent impaired, limited or restricted CJ At least 20 percent but less than 40 percent impaired, limited or restricted CK At least 40 percent but less than 60 percent impaired, limited or restricted CL At least 60 percent but less than 80 percent impaired, limited or restricted CM At least 80 percent but less than 100 percent impaired, limited or restricted CN 100 percent impaired, limited or restricted Changing & Maintaining Body Position     Therapy Functional Reporting Therapy G Codes are: G8981 Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals G8982 Changing & maintaining body position functional limitation, projected...

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