Reporting Severity/Complexity for Functional Limitation

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
April 26th, 2017

For each nonpayable functional G-code, one of the modifiers listed below must be used to report the severity/complexity for that functional limitation. The severity modifiers reflect the beneficiary’s percentage of functional impairment as determined by the clinician furnishing the therapy services.

Functional Limitation Severity Modifier Codes


CH  0 percent impaired, limited or restricted
CI   At least 1 percent but less than 20 percent impaired, limited or restricted
CJ   At least 20 percent but less than 40 percent impaired, limited or restricted
CK   At least 40 percent but less than 60 percent impaired, limited or restricted
CL   At least 60 percent but less than 80 percent impaired, limited or restricted
CM  At least 80 percent but less than 100 percent impaired, limited or restricted
CN   100 percent impaired, limited or restricted

Functional Limitation Therapy Modifier Codes (Use the following modifiers below to indicate the therapy service):


GO     Occupational Therapy
GP      Physical Therapy
GN     Speech-Language Pathology

References:

Reporting Severity/Complexity for Functional Limitation. (2017, April 26). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/reporting-severity-complexity-for-functional-limitation-31526.html

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