Billing Updates | G-Codes and C-modifiers for chiropractors working with PTs
Genesis’ Vericle billing platform has been updated with G-Codes and C-modifiers to improve compliance for all clients who work with a physical therapist in their chiropractic clinics.
Medicare is now requiring that G-Codes and C-modifiers are included on your physical therapy claims and documentation. This change is very complex and can not be done from memory alone. If these requirements are not met, providers will not get paid by Medicare and these claims will be denied.
The G-Codes are used on your Initial Evaluations, Progress notes/Re-evals and Discharge visits to track the patient’s progress in reaching their goals. These codes are used to demonstrate medical necessity and ensure that the patient is getting better. In addition to billing out these G-Codes, providers also have to add C-modifiers depending on the severity of the patient’s condition. Providers also need to use these codes in their documentation and ensure that it is supported with functional testing (e.g., Dash, Tinetti, etc). Any claims submitted after July 1, 2013 that do not have G-Codes on the required visits will be denied. If these findings are not documented, the audit risk increases significantly.