Functional Limitation Reporting (FLR) (i.e. G-codes) has been required for dates of service on and after July 1, 2013 for Medicare beneficiaries receiving outpatient therapy services being billed under their Part B Medicare benefits. I still receive many questions when G-codes have to be reported on the claim form. Many of the questions I receive concern if a therapist only bills an L code for an orthosis during the patients initial visit, do I need to report G-codes? Another question I receive is are G-codes required if on the first visit, I only bill CPT code 97542 for a wheelchair assessment or CPT code 97760 for an orthotic assessment and I do not bill a physical therapy or occupational therapy evaluation CPT code. Lastly, speech-language pathologists ask if they need to report G-codes when they are performing a modified barium study on a Medicare beneficiary who is under observation status or in the emergency department of the hospital?
In this article, I will answer these questions plus provide in what other situations and time frames G-codes are required to be reported on the claim form.
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