Medicare Function-related G-codes

[sjrandall]

I bill to Medicare for PT, OT & SLP services with a POS 62 (CORF). Medicare has implemented using Function-related HCPCS G-codes beginning on 1/1/13 and I am getting confused on when to exactly use them.  A few questions I have are....

1.  Do I use a "current" AND "goal" code on the initial therapy DOS?
2.  On every 10th treatment day, do I use a "current" and "goal" code again or just a "goal" code?
3.  On the last day of treatment for each claim (using TOB 743-Continuing) do I use just the "goal" code?

The "discharge" code is totally easy to understand but I just want to clarify when the other two codes get used and how often.  I have printed the CMS Manual (Pub 100-04) but it has me asking these questions.   The last thing I want to do is get them denied and have to re-bill.

[bumbleb]

This is my understanding of what is needed (I do OP PT billing):

1. Yes -  you need both goals
2. You need both goals again (you are re-verifying the projected goal)
3. You will need again the current and goal

Our PTs have not started using the codes yet - will start implementing it at the end of Feb in case Medicare 'tweaks' the process.
Although Medicare has a date of 1/1/13, you have until 7/1/13 before they will not pay, so you have time to get it figured out and billed correctly

HTH

[sjrandall]

HTH,

THANK YOU, THANK YOU, THANK YOU!!!