G-codes Archives | WebPT

article

Medicare Part A vs. Part B: What PTs, OTs, and SLPs Need to Know

Whether you’re just starting out as a Medicare provider—or you’re making the switch from inpatient to outpatient—there’s a lot to keep straight when it comes to the complicated rules, regulations, and policies that govern Original Medicare (which consists of both Part A and Part B).

Read More
article

CMS’s Final Bow: The 2019 Final Rule

Last week, the Centers for Medicare and Medicaid Services (CMS) published its 2019 final rule. Clocking in at just over 2,300 pages, the final rule isn’t exactly a light read—especially because the legal lingo can be harder to interpret than Shakespearean verse. Luckily, we have the script—with all its twists and turns—decoded and ready for you to review.

Read More
article

Ain’t Nothin’ But a G-Code, Baby. What You Need to Know About the New G-Codes.

Like the ’90s hip-hop-themed title of this blog post implies, Functional Limitation Reporting G-codes may be new, but they’re nothing to fret over. Essentially, effective July 1, 2013, CMS began requiring therapists to report new G-codes in an effort to further emphasize function and functional progress in therapy treatment. But the good news is that you should already be assessing—and documenting—functional progress as part of your short- and long-term goal setting at the initial evaluation, tenth visit (at least), and discharge. Now, all you need to do is assign a G-code that reflects that progress.

What’s a G-Code?

CMS uses G-codes to collect information about its beneficiaries’ functional limitations via claim forms. As we wrote here, “CMS will use all of this information to better understand the beneficiary population that uses therapy services and how their functional limitations change as a result of the therapy they complete. Furthermore, CMS will use the data they collect to reform future payment structures.”

There are 42 codes.

There are 42 G-codes available to choose from to best describe your patient’s primary functional limitation (i.e., the main reason that patient sought out therapy services). Here are just a few:

Mobility: Walking and Moving Around
  • G8978 Mobility: walking and moving around functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8979 Mobility: walking and moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8980 Mobility: walking and moving around functional limitation, discharge status, at discharge from therapy or to end reporting
Changing and Maintaining Body Position
  • G8981 Changing and maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8982 Changing and maintaining body position functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8983 Changing and maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
Self Care
  • G8987 Self care functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8988 Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8989 Self care functional limitation, discharge status, at discharge from therapy or to end reporting
Other PT/OT Primary Functional Limitation
  • G8990 Other physical or occupational primary functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8991 Other physical or occupational primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8992  Other physical or occupational primary functional limitation, discharge status, at discharge from therapy or to end reporting
Other PT/OT Subsequent Functional Limitation
  • G8993 Other physical or occupation subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8994 Other physical or occupational subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8995 Other physical or occupational subsequent functional limitation, discharge status, at discharge from therapy or to end reporting
Swallowing
  • G8996 Swallowing functional limitation, current status, at therapy episode outset and at reporting intervals
  • G8997 Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
  • G8998 Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting

Other categories include motor speech, spoken language comprehension and expression, attention, memory, voice, and other SLP functional limitation. If your patient’s functional limitation does not fit into one of the predefined categories, then you can use the “other” category. For a full list of the FLR G-codes, check out this blog post.

Download the Therapists’ Guide to FLR now.

Access full G-code lists, documentation instructions, and functional limitation reporting examples in our PDF handbook. Enter your email address below, and we’ll send it your way.

Read More
article

Functional Limitation Reporting Refresher

The rehab therapy industry is abuzz with PQRS talk right now. In case you missed it: PQRS as it exists today is dunzo. In 2017, it’ll be replaced with the Merit-Based Incentive Payment System, or MIPS. Unfortunately, though—and yes, it is unfortunate—PTs, OTs, and SLPs are not required to complete MIPS reporting until 2019. (And the jury is still out as to whether they’ll be able to voluntarily participate before then.)

Read More
article

Medicare Part A vs. Part B: What PTs, OTs, and SLPs Need to Know

Whether you’re just starting out as a Medicare provider—or you’re making the switch from inpatient to outpatient—there’s a lot to keep straight when it comes to the complicated rules, regulations, and policies that govern Original Medicare (which consists of both Part A and Part B). But if you want to receive reimbursement for your services, you’ve got to know how to navigate the murky Medicare waters.

Read More
article

PQRS 2016 Measures

While PQRS measures specifications won’t be available until December, we do know which measures are available for 2016. Here’s the breakdown by specialty:

Read More
article

Do You Know Your Modifiers? [Quiz]

It’s a mad, mad, mad, mad Medicare world, and unfortunately, just about every regulation requires a modifier. If you apply the wrong modifier—or forget one entirely—then your clinic suffers decreased payments or flat-out denials. Even worse, if you amass enough modifier mistakes, you make your practice vulnerable to an audit.

Read More