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Functional limitation reporting for multiple diagnoses

Sally Posted Mon 21st of July, 2014 16:11:44 PM

I've had issues with denials on therapy claims for Medicare when we have started one diagnosis with a set of G codes and then the patient has an additional diagnosis added and we report another set of codes. Can anyone give accurate instructions on how to report multiple FLR codes without multiple denials? Thank you.

SuperCoder Answered Tue 22nd of July, 2014 04:03:17 AM

You only report one (1) limitation at a time. Even if the patient has two or three functional limitations, you still only report one (1) functional limitation at a time. If you are treating a patient for multiple conditions and you would like to report a second or third functional limitation, you must first report an appropriate goal G-code and a discharge G-code before you are able to report the next functional limitation. You never report two functional limitations at the same time.

You need to end reporting on the first functional limitation by reporting the appropriate goal and discharge status codes before reporting on a second functional limitation can begin.
Discharge reporting applies in all situations, except when the patient unexpectedly does not return to therapy and discharge information is not available.

For more information, you may refer following link:

http://www.cms.gov/Medicare/Billing/TherapyServices/Downloads/Functional-Reporting-PT-OT-SLP-Services-FAQ.pdf.

Thanks !!

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