Introduction; G-Codes And Modifiers - biodex 950-400 User Manual

1. Introduction

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 such as physical
therapists, occupational therapists, speech-language pathologists, physicians, physician
assistants, nurse practitioners, and clinical nurse specialists.
Figure 1.1. Sample Claim Form with G-code and Impairment Modifier
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