• Common Questions from our G-Code Denials Webinar: Part 2 Image

    articleJul 30, 2014 | 4 min. read

    Common Questions from our G-Code Denials Webinar: Part 2

    I heard that some private insurance carriers are now requiring functional limitation reporting. Is this true? Some non-Medicare insurers do require functional limitation reporting (e.g., Texas Workers' Compensation). Check out this blog post to see a list of the ones we know about right now. Keep in mind, however, that this list is ever-changing—so if you’re unsure of whether a particular plan requires FLR, be sure to inquire directly with the carrier. If I did not submit …

  • Common Questions from our G-Code Denials Webinar: Part 1 Image

    articleJul 29, 2014 | 6 min. read

    Common Questions from our G-Code Denials Webinar: Part 1

    Today’s blog post comes from WebPT writers Brooke Andrus and Erica Cohen. If a patient has more than one functional limitation associated with a single diagnosis, should I report G-codes and severity modifiers for all of them? No. Medicare will only accept functional limitation reporting (FLR) data for one primary functional limitation per case. Therefore, if the patient has multiple functional limitations associated with a single diagnosis, you'll need to determine which one represents the patient's primary …

  • Stop the Denials! How to Report G-Codes so You Get Paid. Image

    webinarJul 25, 2014

    Stop the Denials! How to Report G-Codes so You Get Paid.

    It’s been more than a year since Medicare’s functional limitation reporting (FLR) mandate went into effect. You’d think everything would be hunky-dory by now. Unfortunately, though, rehab therapists have been forced to navigate more than a few hiccups and glitches—many of which cause claim denials. Exasperating? Certainly. Insurmountable? No way, José! Join WebPT founder and COO Heidi Jannenga and PT compliance expert Rick Gawenda of Gawenda Seminars as they tackle Medicare’s many FLR curveballs. In addition to …

  • Update: New Details on Functional Limitation Reporting Issues Image

    articleMay 12, 2014 | 11 min. read

    Update: New Details on Functional Limitation Reporting Issues

    In February, we posted a blog post about a glitch in Medicare’s processing system that was causing claim denials in certain functional limitation reporting cases—specifically, in cases involving complex discharge or treatment scenarios. You can read that blog post in its entirety here . It is imperative to remember that Medicare can only accept data for one functional limitation per patient regardless of how many concurrent cases exist for that patient. Since writing our original post , …

  • When to Report Discharge Codes with Functional Limitation Reporting Image

    articleMar 5, 2014 | 3 min. read

    When to Report Discharge Codes with Functional Limitation Reporting

    Lately, there’s been a bit of confusion surrounding Medicare’s requirements for submitting functional limitation reporting (FLR) discharge codes. Due to a “glitch” in the way Medicare processes claims containing FLR data, some therapists have received claim denials for cases involving tricky discharge reporting scenarios. So, we’ve put together a guide to address some common head-scratching situations. Read on to learn when you need to discharge and when you don’t. Patient Self-Discharges and Returns After 60 or More …

  • How to Complete Functional Limitation Reporting in WebPT Image

    articleFeb 19, 2014 | 4 min. read

    How to Complete Functional Limitation Reporting in WebPT

    As of July 1, 2013, the Centers for Medicare and Medicaid Services (CMS) requires that therapists complete functional limitation reporting (FLR)—through the use of  G-codes and severity modifiers —on all eligible Medicare Part B patients at the initial evaluation, re-evaluation if applicable, every progress note (minimum of every ten visits), and discharge in order to receive reimbursement for their services. Today, several other private insurance companies also require FLR data as a condition of reimbursement. Good thing …

  • articleDec 26, 2013 | 5 min. read

    Most Frequently Asked Questions from our PQRS Webinar

    Once I pick my measures within WebPT, am I stuck with those throughout the year or can I change them? Yes, whichever measures you select will be your measures for the remainder of the year. You have until March 31, 2014, to make your final selection.   Is the requirement for successful reporting with the back pain measures group 20 patients per therapist or 20 patients per practice? It’s 20 patients per therapist. It doesn’t matter if …

  • articleDec 23, 2013 | 2 min. read

    Changes to PQRS Measures Specifications for 2014

    On Friday, Medicare released the 2014 specifications for individual PQRS measures. Not much has changed compared to last year; however, there are a few noteworthy differences, which we’ve detailed below. (Please note that there weren’t any major changes for speech language pathologists.) Measure 131: Pain Assessment Physical and occupational therapists can now report this measure during re-evaluations (97002 and 97004). In 2013, they could only report it during initial evaluations. Measure 155: Falls POC In 2013, therapists …

  • articleNov 21, 2013 | 4 min. read

    How an EMR Helps You Stay Medicare Compliant

    Confidence and compliance are two words rehab therapists rarely put in the same sentence. Sure, they know that therapy cap requirements, functional limitation reporting , PQRS , the 8-minute rule , and MPPR are all Medicare regulations. But beyond that, memories get a bit fuzzy—and that’s understandable. It’s a lot to keep straight, let alone accurately follow. Yet, Medicare requires compliance; otherwise, they’ll deny payment or dole out fines. They don’t care that you’re busy treating patients, …

  • The Scoop on PQRS Image

    articleNov 18, 2013 | 5 min. read

    The Scoop on PQRS

    What is PQRS? The Centers for Medicare and Medicaid Services (CMS) developed Physician Quality Reporting System (PQRS), which mandates that eligible professionals meet standards for satisfactory reporting. If you are not PQRS-compliant in 2014, CMS will assess penalties. However, we do not yet know what the penalty amount is or how CMS will assess it. There also is a chance that CMS will provide incentive payments for successfully completing PQRS, as they did in 2013. Again, we …

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