If you are new to G-codes, the best way to describe them is as quality data codes that rehab therapy providers (including physical therapists, occupational ones and speech-language pathologists) include on their Medicare claim forms to fulfill the requirements for the Functional Limitation Reporting (FLR).
Functional Limitation Reporting, on the other hand, is a CMS reporting regulation for physical therapists, occupational ones and speech-language pathologists who provide outpatient therapy services to Medicare beneficiaries. The goal here is to establish an evidence-based connection between rehab therapy treatment and patient progress.
The sets of G-codes for FLR are unique – and CMS uses the sets of them to track information about the Medicare beneficiaries’ function and condition. Below, we are listing all of the 42 available FLR G-codes organized by category and specialty, followed by a list of (70) modifiers and therapy modifiers.
Mobility: Walking & Moving Around
| G-Code |
Description
|
Short Descriptor |
| G8978 Mobility |
Walking and moving around functional limitation, current status, at therapy episode outset, and at reporting intervals.
|
Mobility current status |
| G8979 Mobility |
Walking and moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting.
|
Mobility goal status |
| G8980 Mobility |
Walking and moving around functional limitation, discharge status, at discharge from therapy or to end reporting.
|
Mobility discharge status |
Changing & Maintaining Body Position
| G-Code |
Description |
Short Descriptor |
| G8981 |
Changing and maintaining body position functional limitation, current status, at therapy episode outset, and at reporting intervals. |
Body position current status |
| G8982 |
Changing and maintaining body position functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting. |
Body position goal status |
| G8983 |
Changing and maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting. |
Body position discharge status |
Carrying, Moving & Handling Objects
| G-Code |
Description |
Short Descriptor |
| G8984 |
Carrying, moving, and handling objects functional limitation, current status, at therapy episode, and at reporting intervals |
Carry current status |
| G8985 |
Carrying, moving, and handling objects functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
Carry goal status |
| G8986 |
Carrying, moving, and handling objects functional limitation, discharge status, at discharge from therapy or to end reporting |
Carry discharge status |
Self Care
| G-Code |
Description |
Short Descriptor |
| G8987 |
Self care functional limitation, current status, at therapy episode outset, and at reporting intervals. |
Self care current status |
| G8988 |
Self care functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Self care goal status |
| G8989 |
Self care functional limitation, discharge status, at discharge from therapy or to end reporting |
Self care discharge status |
Other PT/OT Primary Functional Limitation
| G-Code |
Description |
Short Descriptor |
| G8990 |
Other physical or occupational primary functional limitation, current status, at therapy episode outset, and at reporting intervals |
Other PT/OT current status |
| G8991 |
Other physical or occupational primary functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting |
Other PT/OT goal status |
| G8992 |
Other physical or occupational primary functional limitation, discharge status, at discharge from therapy to end reporting |
Other PT/OT discharge status |
Other PT/OT Subsequent Functional Limitation
| G-Code |
Description |
Short Descriptor |
| G8993 |
Other physical or occupational subsequent functional limitation, current status, at therapy episode outset, and at reporting intervals |
Sub PT/OT current status |
| G8994 |
Other physical or occupational subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Sub PT/OT goal status |
| G8995 |
Other physical or occupational subsequent functional limitation, discharge status, at discharge from therapy or to end reporting |
Sub PT/OT discharge status |
Speech-Language Pathology G-Codes
Swallowing
| G-Code |
Description |
Short Descriptor |
| G8996 |
Swallowing functional limitation, current status, at therapy episode outset, and at reporting intervals |
Swallow current status |
| G8997 |
Swallowing functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Swallow goal status |
| G8998 |
Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting |
Swallow discharge status |
Motor Speech
| G-Code |
Description |
Short Descriptor |
| G8999 |
Motor speech functional limitation, current status, at therapy episode outset, and at reporting intervals |
Motor speech current status |
| G9186 |
Motor speech functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Motor speech goal status |
| G9158 |
Motor speech functional limitation, discharge status, at discharge from therapy or to end reporting |
Motor speech discharge status |
Spoken Language Comprehension
| G-Code |
Description |
Short Descriptor |
| G9159 |
Spoken language comprehension functional limitation, current status, at therapy episode outset, and at reporting intervals |
Spoken language comprehension current status |
| G9160 |
Spoken language comprehension functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Spoken language comprehension goal status |
| G9161 |
Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting |
Spoken language comprehension discharge status |
Spoken Language Expression
| G-Code |
Description |
Short Descriptor |
| G9162 |
Spoken language expression functional limitation, current status, at therapy episode outset, and at reporting intervals |
Spoken language expression current status |
| G9163 |
Spoken language expression functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Spoken language expression goal status |
| G9164 |
Spoken language expression functional limitation, discharge status, at discharge from therapy or to end reporting |
Spoken language expression discharge status |
Attention
| G-Code |
Description |
Short Descriptor |
| G9165 |
Attention functional limitation, current status, at therapy episode outset, and at reporting intervals |
Attention current status |
| G9166 |
Attention functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Attention goal status |
| G9167 |
Attention functional limitation, discharge status, at discharge from therapy or to end reporting |
Attention discharge status |
Memory
| G-Code |
Description |
Short Descriptor |
| G9168 |
Memory functional limitation, current status, at therapy episode outset, and at reporting intervals |
Memory current status |
| G9169 |
Memory functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Memory goal status |
| G9170 |
Memory functional limitation, discharge status, at discharge from therapy or to end reporting |
Memory discharge status |
Voice
| G-Code |
Description |
Short Descriptor |
| G9171 |
Voice functional limitation, current status, at therapy episode outset, and at reporting intervals |
Voice current status |
| G9172 |
Voice functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Voice goal status |
| G9173 |
Voice functional limitation, discharge status, at discharge from therapy or to end reporting |
Voice discharge status |
Other Speech-Language Pathology
| G-Code |
Description |
Short Descriptor |
| G9174 |
Other speech-language pathology functional limitation, current status, at therapy episode outset, and at reporting intervals |
Other speech-language pathology current status |
| G9175 |
Other speech-language pathology functional limitation, projected goal status, at therapy episode outset, at reporting intervals, at discharge or to end reporting |
Other speech-language pathology goal status |
| G9176 |
Other speech-language pathology functional limitation, discharge status, at discharge from therapy or to end reporting |
Other speech-language pathology discharge status |
Functional Limitation Severity Modifier Codes
| Modifier |
Impairment Limitation Restriction |
| CH |
0% impaired, limited, or restricted |
| CI |
At least 1% but less than 20% impaired, limited, or restricted |
| CJ |
At least 20% but less than 40% impaired, limited, or restricted |
| CK |
At least 40% but less than 60% impaired, limited, or restricted |
| CL |
At least 60% but less than 80% impaired, limited, or restricted |
| CM |
At least 80% but less than 100% impaired, limited, or restricted |
| CN |
100% impaired, limited, or restricted |
Functional Limitation Therapy Modifier Codes
Therapy modifiers indicate the type of therapy service you’re providing.
| Modifier |
Services Delivered Under Outpatient POC |
| GO |
Occupational Therapy |
| GP |
Physical Therapy |
| GN |
Speech-Language Pathology |
If you are a practice that sees Medicare patients or Medicare HMOs, it is super important to know how and when using G-codes is appropriate. If you use a EMR software, it is extremely helpful to have these codes populate from the EMR into the billing software automatically. As the provider, it allows me to know that the functional deficits I am seeing with a patient translates directly into the billing. With www.HENO.io it is a simple process and makes my job as the PT so much easier!
