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This course may be eligible toward Category 2 continued competency requirements for Kentucky.

Webinar Description : Beginning January 1, 2013, the Centers for Medicare and Medicaid Services (CMS) will begin collection of information regarding the beneficiaries function and condition, therapy services furnished, and outcomes achieved on patient function on the claim forms. All practice settings that provide outpatient therapy services must include this information on the claim form. Specifically, the policy will apply to physical therapy(PT), occupational therapy (OT), and speech-language-pathology (SLP) services furnished in hospitals, critical access hospitals, skilled nursing facilities, comprehensive outpatient rehabilitation facilities (CORFs), rehabilitation agencies, home health agencies (when the beneficiary is not under a home health plan of care), and in private offices of therapists, physicians and nonphysician practitioners. To ensure a smooth transition, CMS sets forth a testing period from January 1, 2013, until July 1, 2013. After July 1, 2013, claims submitted without the appropriate G-codes and modifiers would be returned unpaid.

Participants will learn how to report patient functional limitation information on claims using the new nonpayable functional G-codes and with the severity modifiers on claims. In addition, the G-codes and severity modifiers used in the functional reporting are required to be documented in the patient’s medical record of therapy services.

Specifically, this call will include an overview of the new functional reporting requirement, including effective dates, and information on:

·         nonpayable G-codes used to report functional limitations
·         modifiers used to report the severity of functional limitations
·         reporting frequency
·         documentation requirements

Presenter: Heather Smith, PT, MPH : Heather Smith currently serves as the Program Director of Quality for APTA.  Heather previously worked for New York Presbyterian Hospital as the Manager of Core Measures, with responsibility for all publically reported core measure sets and quality improvement projects associated with these measures.  In addition, she worked on a variety of other quality initiatives as well as regulatory preparedness for multiple campuses within New York Presbyterian’s 2,300 bed hospital system.  Prior to her role at New York Presbyterian, she worked at the University of Pennsylvania Health System where she also served in a quality improvement position for over two years.  Her transition into quality was facilitated in part by the acquisition of her Masters in Public Health from Drexel University.  Previous to her role in quality improvement, she was a practicing clinician for over ten years with the majority of her focus on orthopedics in the outpatient setting.

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