Dollars $$ Sense Claims-Based Functional Reporting: Further Clarifications Dollars $$ Sense
Dollars $$ Sense  |   November 01, 2013
Dollars $$ Sense
Author Affiliations & Notes
  • Dee Adams Nikjeh
    ASHA Health Care Economics Committee, Co-Chair
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Swallowing, Dysphagia & Feeding Disorders / Research Issues, Methods & Evidence-Based Practice / Practice Management / Speech, Voice & Prosody / Dollars $$ Sense
Dollars $$ Sense   |   November 01, 2013
Dollars $$ Sense
SIG 3 Perspectives on Voice and Voice Disorders, November 2013, Vol. 23, 71-73. doi:10.1044/vvd23.3.71
SIG 3 Perspectives on Voice and Voice Disorders, November 2013, Vol. 23, 71-73. doi:10.1044/vvd23.3.71
On July 1, 2013, all therapy claims submitted under Medicare Part B and services under Comprehensive Outpatient Rehabilitation Facilities (CORF) were required to document nonpayable G-codes with severity modifiers for one functional limitation each time an evaluation is billed, on or before every 10th treatment day, and at discharge. This information, in addition to the clinical tool used to determine the severity level, must also be documented in the Medicare beneficiary’s medical record. The Centers for Medicare and Medicaid (CMS) examined ASHA’s National Outcomes Measurement System (NOMS) and chose 7 of 16 Functional Communication Measures (FCMs) and added one more “other” category for a total of 8 speech-language pathology related functional limitations. Each functional limitation has a corresponding set of 3 G-codes that represent current status, projected goal status, and discharge status. CMS adopted a 7-point severity/complexity scale to represent each functional limitation that closely correlates to the NOMS 7-point impairment scale for each FCM. The three G-codes that pertain to voice are:
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