G-Codes; Introduction To G-Codes And Modifiers - biodex 950-401 Application/Operation Manual

5. G-Codes

Introduction to G-Codes and Modifiers

G-codes are a method of recording and tracking a patient's functional limitation at the outset of
therapy, during the course of therapy, and at the time of discharge.
The codes are now required by Medicare for outpatient therapy services billed under Medicare
Part B in order to collect data on beneficiaries' functional outcomes from therapy services
provided. Claims that do not include the required functional data will be returned for re-
submission.
Functional tests will be used to report a functional limitation category (G-code) and a
percentage of impairment (Severity Code Modifier).
Severity Code Modifiers are a series of impairment level ranges made up of approximately 20
percentage points each.
The G-codes will be used by those who provide outpatient therapy services. These include
physical therapists, occupational therapists, speech-language pathologists, physicians,
physician assistants, nurse practitioners, and clinical nurse specialists.
Figure 5.1. Sample Claim Form with G-code and Impairment Modifier
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