Don’t report functional limitation codes on every therapy claim

Why This Topic Matters

Therapy claims can be denied if the required functional limitation reporting is omitted or not reported at the appropriate points in the care episode. The article helps readers understand CMS timing and claim-submission requirements tied to therapy documentation and evaluation services.

Article Sections

1. Reporting functional limitation information on therapy claims

   Introduces the reporting framework for therapy services and the general circumstances when functional limitation information is included on claims. It also notes the relationship between claim reporting and therapy episode timing.

2. Prepare for more frequent progress reports

   Summarizes the updated progress-reporting schedule and its connection to therapy claim reporting. It discusses the manual guidance that aligns progress documentation with functional reporting.

3. Evaluations always require G-codes

   Covers the therapy and evaluation context in which functional reporting is addressed, including references to Medicare therapy categories and evaluation-related services. It also notes the article’s discussion of when the reporting elements are associated with evaluative procedures.