CMS Provides Additional Clarification on Reporting Requirements for Functional Limitation Codes [06-21-13]

Filed under: Industry Updates — Editor @ 9:34 am

cmsannouncementThe Centers for Medicare and Medicaid Services (CMS) recently provided¬† additional clarification on the functional therapy reporting requirements effective for Part B therapy providers with dates of service on or after July 1, 2013. In our update from Tuesday, June 18th, CMS indicated “for beneficiaries whose treatment began prior to July 1, 2013 but for whom Functional Reporting information has not been submitted, the first claim submitted with a DOS on or after July 1, 2013 should be treated as the initial claim and include the required Functional Reporting.” CMS has provided the following additional clarification for these continuing claims of service: the July claim does not need to include an evaluation or re-evaluation code to begin transmitting the functional limitation codes. The first appointment would be considered a 10 day progress note coded with the G-codes and their related modifiers. This visit will then start the count towards their next progress reporting date.

Marden will continue to monitor this topic and send out the information as it is released. Click Functional-Reporting-PT-OT-SLP-Services-FAQ for the recently posted frequently asked questions by CMS.

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