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Which one of the following statements incorrectly describes a situation in which a therapist must document the Functional G Code?

1) The patient's functional status on the 6th OP visit in which treatment was provided by the PTA
2) The patient's functional status at the time of initial OP therapy evaluation
3) The patient's functional status at the OP therapy discharge visit
4) The patient's functional status on or before the 10th OP therapy visit

User Mttmllns
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1 Answer

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Final answer:

The incorrect situation is the 10th OP therapy visit for documenting the Functional G Code, as there is no strict requirement for documenting on or before the 10th visit unless it coincides with another reporting criterion.

Step-by-step explanation:

The situation that incorrectly describes when a therapist must document the Functional G Code is option 4: The patient's functional status on or before the 10th OP therapy visit. The Centers for Medicare & Medicaid Services (CMS) Functional Reporting Requirements specify that G codes, which are used to express a patient's functional limitation and the severity of that limitation, are required at specific time points throughout the provision of outpatient therapy services. These time points generally include the initial evaluation, specified reporting intervals such as every 10th visit or 30 days, whichever is less, a significant change in condition, and at discharge.

However, there is no specific requirement for documenting G Codes strictly on or before the 10th visit if no other reporting criterion is met. Therefore, the other options correctly describe appropriate situations for documenting the Functional G Code:

  • The patient's functional status at the time of initial OP therapy evaluation
  • The patient's functional status on the 6th OP visit in which treatment was provided by the PTA (Physical Therapy Assistant), assuming this represents a reporting interval or change in condition
  • The patient's functional status at the OP therapy discharge visit

User Mauro Midolo
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