G-codes Archives | Page 2 of 2 | WebPT

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Founder Letter: PQRS 2014

Well, it’s November already, and that means two things: Thanksgiving and Physician Quality Reporting System (PQRS). Sure, PQRS doesn’t involve mouthwatering roasted turkey, savory stuffing, or creamy mashed potatoes, but it has become quite the November tradition for us here at WebPT. You see, this is the time of year that the Centers for Medicare & Medicaid Services (CMS) typically confirms the details of next year’s reporting requirements, thus allowing us to update our PQRS solution (claims- and registry-based reporting) and start our month-long blog and webinar theme of “everything you need to know to be PQRS compliant.”

Unfortunately, this year is shaping up a little differently. As a result of the government shutdown, CMS delayed its November 1 meeting to discuss the 2014 Physician Fee Schedule Proposed Rule—which includes potential PQRS changes—until at least the middle of this month. And until they meet, we won’t know much about what PQRS 2014 will truly entail in terms of reporting requirements, measures, penalties, and incentives—let alone when the government will actually finalize the Proposed Rule. This means that as of today, no one knows for sure:

  • which measures therapists must report
  • how many measures therapists must report
  • whether there will be compliance incentives
  • what penalties will be associated with noncompliance
  • what percentage of patients for whom therapists must complete PQRS reporting

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Functional Limitation Reporting and You: What You Need to Know

Wow, can July 1 really be right around the corner? Seems like yesterday we were only finding out about the requirement to document and report functional limitation G-codes and severity/complexity modifiers, and I think it really was only yesterday that CMS figured out how they would work.

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Gaming the System and Other FLR No-Nos

We all know that functional limitation reporting (FLR)  means (a little) more work for (basically) the same reward. And that can be a hard pill to swallow for many therapists who are already stretched thin as a result of increasing caseloads and increasingly stringent documentation requirements. Even so, taking the easy road—the low road—and gaming the system—and thus, this profession—is not the answer.

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Functional Limitation Reporting: Patient Example

With July 1 right around the corner, we know what’s on your mind: functional limitation reporting (FLR). That’s why we’ve dedicated (almost) this entire month to the ins and outs of G-codes and severity modifiers. But perhaps our discussions have been a little too theoretical for your liking. (We know FLR is one spicy meatball.) If that’s the case, don’t fret. Here’s a more concrete patient example to help solidify your understanding of CMS’s latest regulation. First, some handy dandy references for said example.

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“What Box Does my G-Code Go Into?”: Responding to Outdated Questions Related to Paper Billing Claims

Members often ask: where does my G-code go? Or what box does my NPI go into? Additionally, we—as the WebPT Billing Service—receive such requests as “I need my facility address changed in Box 32” or “I need to use my Tax ID instead of my SSN in box 24j.” But these “boxes” that Members sometimes refer to don’t exist anymore in modern billing. In fact, they’ve become my personal four letter word. For a typical practice, 99% of claim submissions are electronic and sent in an ANSI 5010 837 format. If you are still printing paper claims for more than 1% of your payers, let’s be frank, you’re outdated. And in this situation, trust me, you don’t want to be outdated. 

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Embracing Functional Limitation Reporting

Today’s blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L. By now, I’m sure you’ve heard about functional limitation reporting—also known as claims-based outcome reporting (CBOR) and G-code reporting. Regardless of what your clinic calls it, functional limitation reporting is coming quickly.

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Now That I Know G-Codes Ain’t No Thang, How Do I Implement ‘Em?

Last month, we discussed CMS’s new G-codes in a cleverly titled post, “Ain’t Nothin’ But a G-Code, Baby.” As the name implies, this new functional limitation reporting mandate is not nearly as daunting as you may think. In fact, if you use WebPT, it’s going to be as easy as pie—cherry pie, or maybe apple. Regardless, I digress. Here, we’ll discuss how with just a few clicks, and some clinical judgment, you can easily implement these new codes into your documentation workflow.

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Functional Outcome Measures

By now, I hope most of you are using functional outcome measures. If you haven’t started yet, you might want to consider taking the next few weeks to get prepared and begin the process in January of 2013. Why? Let’s start with the fact that physical therapy documentation is coming under greater scrutiny especially regarding demonstrating the medical necessity of the treatments provided.

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