Functional Limitation Reporting Roadmap

The Affordable Care Act ushers in a new era in physical therapy and is right around the corner.  Functional limitation reporting or G Codes – are one of the many new requirements in physical therapy for the treatment of Medicare patients.  These new requirements have surely caused concerns for many in the industry, rest assured, if you are a TheraOffice On-Site or TheraOffice Web user, you will be compliant by the July 1st deadline.

Although there is no financial incentive to G Codes (like there are for PQRS), reporting these codes will now become a requirement.  The testing period between January 1 and July 1 will not result in any rejected claims; however, once this testing phase is over, any claims without the correct G Codes and modifiers will be returned and denied for all Medicare claims.

We’ve been listening and watching to see what would work best in the practices of TheraOffice users and we have come out with a couple ways to help make your life as easy as possible (at least from a reporting standpoint!)  Below is a roadmap of what we’re working on now:

Step 1 – Update TheraOffice

The first step to adding the G Codes into TheraOffice will begin within the next few weeks!  For TheraOffice On-Site users, an update will be published that contains the normal maintenance fixes and a few new small features.  This update will also contain new features to help make the following download easier…

Step 2 – Manual G Code Testing

The next step will be an update that will add new sections to TheraOffice Documentation which will allow for manual G Code entry and testing.  For TheraOffice On-Site users, this will be a CD update which will need to be updated on each computer and the database.  For TheraOffice Web customers, this will just be a normal downloadable client software update.

Once this update has been applied, the Document Map found in Documentation will now have two new sections: Outcomes and Functional Limitation Reporting (see below).

The Outcomes section will allow for manual free form entry of functional tests or you can integrate with a separate software (that we don’t officially have a name for yet…but we will just call it “MedG” for now).  The Functional Limitation Reporting section that will be added will allow for the therapist to manually enter codes, OR, if using “MedG” the therapist can simply just click on the “Suggest Codes” button to automatically calculate which G Codes to bill for. TheraOffice will recommend the current or discharge CPT codes and the CPT codes as well as the method and modifier.

If the clinic chooses to use “MedG,” the front desk staff will be able to initiate right from TheraOffice Scheduling which patient and tests need to be performed.  It will be included in the drop down options when right clicking on that particular patient’s appointment.

Another option other than having the front desk staff perform the tests would be for the therapist to perform the tests themselves.  In the Documentation module within TheraOffice, the therapist would click the “test with MedG” option that will be integrated into the top toolbar of the new Outcomes section.  The therapist would then be able to choose which tests to perform.

Step 3 – “MedG” (Not the Actual Name) App

“MedG” which is a mobile app for Windows 8 and iPad will allow patients to complete functional tests and then be imported into the new Outcomes section automatically.

After choosing the correct patient and test(s), the front desk staff or therapist would launch “MedG” on a Microsoft Surface or iPad.  If able, the patient will be handed the tablet and the assessment will begin – or the therapist could help the patient with the functional tests.

 

When the patient completes the test, they will return the tablet back to the front desk staff or therapist.  The therapist can then review the test and clarify any questions that the patient might have.  This is a great opportunity for the Therapist to also check progress with the patient. The therapist will then be able to download the scores, tests, and test categories in new Outcomes section of Documentation.

Finally – when in the Charges section of Documentation, any G Codes suggested in the Functional Limitation section will be pulled in much like they are for treatments.

We are excited to get “MedG” and the Functional Limitation Reporting updates out to you as soon as possible.  We understand how important it is for you to begin practicing on these reporting measures during this current testing period.

If you have any questions or suggestions, please feel free to leave your comments below!

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