E. Function-related G-codes
There are 42 functional G-codes, 14 sets of three codes each. Six of the G-code sets are generally for PT and OT functional limitations and eight sets of G-codes are for SLP functional limitations.
The following G-codes are for functional limitations typically seen in beneficiaries receiving PT or OT services. The first four of these sets describe categories of functional limitations and the final two sets describe “other” functional limitations, which are to be used for functional limitations not described by one of the four categories.
NONPAYABLE G-CODES FOR FUNCTIONAL LIMITATIONS
Code Long Descriptor Short Descriptor
Mobility G-code Set
G8978
Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals
Mobility current status
G8979
Mobility: walking & 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 & moving around functional limitation, discharge status, at discharge from therapy or to end reporting
Mobility D/C status
Changing & Maintaining Body Position G-code Set
G8981
Changing & maintaining body position functional limitation, current status, at therapy episode outset and at reporting intervals
Body pos current status
G8982
Changing & maintaining body position functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
Body pos goal status
G8983
Changing & maintaining body position functional limitation, discharge status, at discharge from therapy or to end reporting
Body pos D/C status
Carrying, Moving & Handling Objects G-code Set
G8984
Carrying, moving & handling objects functional limitation, current status, at therapy episode outset and at reporting intervals
Carry current status
G8985
Carrying, moving & 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 & handling objects functional limitation, discharge status, at discharge from therapy or to end reporting
Carry D/C status
Self Care G-code Set
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, and 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 D/C status
The following “other PT/OT” functional G-codes are used to report:
• a beneficiary’s functional limitation that is not defined by one of the above four categories;
• a beneficiary whose therapy services are not intended to treat a functional limitation;
• or a beneficiary’s functional limitation when an overall, composite or other score from a functional assessment too is used and it does not clearly represent a functional limitation defined by one of the above four code sets.
Code Long Descriptor Short Descriptor
Other PT/OT Primary G-code Set
G8990
Other physical or occupational therapy primary functional limitation, current status, at therapy episode outset and at reporting intervals
Other PT/OT current status
G8991
Other physical or occupational therapy 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 therapy primary functional limitation, discharge status, at discharge from therapy or to end reporting
Other PT/OT D/C status
Other PT/OT Subsequent G-code Set
G8993
Other physical or occupational therapy subsequent functional limitation, current status, at therapy episode outset and at reporting intervals
Sub PT/OT current status
G8994
Other physical or occupational therapy subsequent functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
Sub PT/OT goal status
The following G-codes are for functional limitations typically seen in beneficiaries receiving SLP services. Seven are for specific functional communication measures, which are modeled after the National Outcomes Measurement System (NOMS), and one is for any “other” measure not described by one of the other seven.
Code Long Descriptor Short Descriptor
Swallowing G-code Set
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, and at discharge or to end reporting
Swallow goal status
G8998
Swallowing functional limitation, discharge status, at discharge from therapy or to end reporting
Swallow D/C status
Motor Speech G-code Set
(Note: These codes are not sequentially numbered)
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, and 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 D/C status
Spoken Language Comprehension G-code Set
G9159
Spoken language comprehension functional limitation, current status, at therapy episode outset and at reporting intervals
Lang comp current status
G9160
Spoken language comprehension functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
Lang comp goal status
G9161
Spoken language comprehension functional limitation, discharge status, at discharge from therapy or to end reporting
Lang comp D/C status
Spoken Language Expressive G-code Set
G9162
Spoken language expression functional limitation, current status, at therapy episode outset and at reporting intervals
Lang express current status
G9163
Spoken language expression functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
Lang press goal status
G9164
Spoken language expression functional limitation, discharge status, at discharge from therapy or to end reporting
Lang express D/C status
Attention G-code Set
G9165
Attention functional limitation, current status, at therapy episode outset and at reporting intervals
Atten current status
G9166
Attention functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
Atten goal status
Code Long Descriptor Short Descriptor
G9167
Attention functional limitation, discharge status, at discharge from therapy or to end reporting
Atten D/C status
Memory G-code Set
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, and at discharge or to end reporting
Memory goal status
G9170
Memory functional limitation, discharge status, at discharge from therapy or to end reporting
Memory D/C status
Voice G-code Set
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, and at discharge or to end reporting
Voice goal status
G9173
Voice functional limitation, discharge status, at discharge from therapy or to end reporting
Voice D/C status
The following “other SLP” G-code set is used to report:
• on one of the other eight NOMS-defined functional measures not described by the above code sets; or
• to report an overall, composite or other score from assessment tool that does not clearly represent one of the above seven categorical SLP functional measures.
Code Long Descriptor Short Descriptor
Other Speech Language Pathology G-code Set
G9174
Other speech language pathology functional limitation, current status, at therapy episode outset and at reporting intervals
Speech lang current status
G9175
Other speech language pathology functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting
Speech lang goal status
G9176
Other speech language pathology functional limitation, discharge status, at discharge from therapy or to end reporting
Speech lang D/C status
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