Health Information Management

Tip: Don't forget to report severity modifiers for therapy

APCs Insider, August 2, 2013

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CMS introduced seven complexity/severity modifiers to be used with the new therapy G codes in January. Although CMS required that facilities report these G codes and modifiers beginning in January, CMS enacted a six-month testing period that ended July 1.

The seven severity modifiers report percentage of impairment limitation restriction as follows:

  • 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

The therapist, physician, or nonphysician practitioner who furnishes the services is responsible for tracking and documenting the G codes and modifiers reported on the claim in the beneficiary's medical record.

This tip is adapted from “Correctly report G codes for physical therapy” in the July issue of Briefings on APCs.



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