Wiki MCR Limitation G Codes, and Severity Modifiers

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msingh23

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Need advise on visit for MCR insurance to have Functional Limitation G Codes, and Severity Modifiers. Do we carry over the visit number to a new year for example to accumulate to 10th ....Patient was seen by therapist for 8 visits in 2013 then a new therapist same Dx at same office in 2014 do we continued the counting of visit to 10Th visit OR start over from 1????
Also if a patient was seen 6 months later , same Dx due to a flare up do we continued the visit count.

Thanks
 
G-Codes and severity modifiers are based on plan of care regardless of year span. If the plan of care includes 15 visits than G-codes should be submitted for the initial visit, the 10th visit and the discharge (15th visit) regardless of year. If the patient is discharged and the patient returns again with the same issue a new plan of care is initiated and thus a new set of G-codes started. Lets say the patient stops coming and is never formally discharged with the appropriate G-codes those G-codes are active for 60 days. If the patient returns after 60 days of inactivity than you can begin a new set of G-codes and modifiers. This holds true for your entire PT group regardless of therapist.
 
Billable Re - Evaluation OR not

Can Therapist bill for revaluation when such time span? If Not what is a billabe re- evaluaton for MCR other than change in dx of body areas.
Have a patient not in PT for 3 mths, now returning re evaluation done not sure if re evaluation shoul be bill OR not, please advise.
Thanks
 
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