Medical Billing Forum
Billing => Billing => : sjrandall February 06, 2013, 12:56:02 AM
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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.
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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
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HTH,
THANK YOU, THANK YOU, THANK YOU!!!