G-Code Clarification

By RehabCare

Since the requirement to include G-codes and severity/complexity modifiers to indicate a patient’s functional status on all therapy claims began on July 1, 2013, there has been confusion among providers. In a recent McKnight’s Long Term Care News column, Shelly Mesure, MS, OTR/L, addressed the three most common areas of confusion for providers.

First off, it is important for therapists to recognize that the cognition/memory code of G9168 – G9170 is only to be used for speech therapy – and does not apply to either physical or occupational therapies as it was not included in the PT/OT code list.

In addressing the confusion over whether physical and occupational therapists can use the same G-codes at the same time, Shelly indicated that it is okay to do so as they related to each discipline’s goals, but recommended that the therapist clearly indicate the difference in the scope of practice so as to avoid an appearance of duplication of services.

The last issue of whether assistants can complete the G-codes is still a bit unclear. While a therapist must determine the G-code and appropriate modifiers, it is noted that the therapy assistant may be able to document the updates in accordance with the schedule set forth in the regulation. However, as is stated in the column, as with most significant changes to reporting regulations, there are many areas that still need to be addressed and “ironed out.”

At RehabCare, we are continuing to work to establish best practices regarding the inclusion of G-codes, and we will continue to partner with other national stakeholders to develop industry standards.

By RehabCare