Appropriate Reporting of G-Codes & C-Modifiers by Therapists Who Treat Chronic Wounds
ISBN or ISSN
Publication Date / Copyright Date
HMP Communications, LLC
Passed in 2012, the Middle Class Tax Relief & Jobs Creation Act requires the Centers for Medicare & Medicaid Services (CMS) to implement a data collection system for outpatient therapy services provided to Medicare beneficiaries. The process is required to collect data on beneficiary function during the course of therapy services in order to provide a better understanding of beneficiary conditions, outcomes, and expenditures. The goal is for this data to be used to develop a new payment system for outpatient therapy services, which includes physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP). The process that was developed is termed “functional limitation reporting” (FLR) and consists of “G-codes” and severity modifiers (“C-modifiers”), which will be explained in further detail within this article. As of July 1, 2013, any therapy service claims submitted without the applicable G-codes and modifiers are returned as unpaid.
Medicine and Health Sciences
Data Collection, Therapy, Beneficiary Conditions, Outcomes, Expenditures, Physical Therapy, Occupational Therapy, Speech-Language Pathology
Hettrick, Heather; Woelfel-Dyess, Stephanie; and Hamm, Rose, "Appropriate Reporting of G-Codes & C-Modifiers by Therapists Who Treat Chronic Wounds" (2014). Department of Physical Therapy Faculty Articles. 33.