by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Aug10th,2015 - Reviewed/Updated Aug7th
Modifiers GN, GO, and GP refer only to services provided under plans of care for physical therapy, occupational therapy and speech - language pathology services. They should never be used with codes that are not on the list of applicable therapy services. For example, respiratory therapy services, or nutrition therapy services shall not be represented by therapy codes which require GN, GO, and GP modifiers.
Contractors edit institutional claims to ensure the following:
• that a GN, GO or GP modifier is present for all lines reporting revenue codes 042X, 043X, or 044X.
• that no more than on e GN, GO or GP modifier is reported on the same service line.
• that revenue codes and modifiers are reported only in the following combinations:
• Revenue code 42x (physical therapy) lines may only containmodifier GP
• Revenue code 43x (occupational therapy) lines may only containmodifier GO
• Revenue code 44x (speech - language pathology) lines may only containmodifier GN.
• that discipline - specific evaluation and re - evaluation HCPCS codes are always reported with the modifier for the associated discipline (e.g.modifier GPwith a HCPCS code for a physical therapy evaluation.
There are 42 functional G-codes, 14 sets of three codes each. Six of the G-code sets generally describe PT and OT functional limitations, and eight sets of G-codes generally describe SLP functional limitations. For more information click on the link below to see a quick reference chart.
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
Modifiers GN, GO, and GP refer only to services provided under plans of care for physical therapy. (2015, August 10). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/modifiers-gn-go-and-gp-refer-only-to-services-provided-under-plans-of-care-for-physical-therapy-31635.html
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