• Functional Limitation Reporting (FLR) Under Medicare: Tests and Measures for High-Volume Conditions

     
     

    Starting July 1, 2013, all practice settings that provide outpatient therapy services must include information regarding the beneficiaries' functional limitations on the claim form. The information will be reported using nonpayable G-codes and modifiers on the claim forms that capture the data on the functional limitation. Physical therapists should use their clinical judgment in addition to data from tests and measurement tools to determine the severity of the patient's functional limitation.

    Obtaining Tests & Measures

    Scroll down this page for lists of tests and measures that APTA section and EDGE (Evaluation Database to Guide Effectiveness) workgroups identified for the top (highest-volume) conditions in their content areas. (Read more on how this was done.) Many of the listed tests are linked to the actual test. Because tests usually are copyrighted, APTA is securing licenses to offer them via PTNow for member use. Links are posted as they become available.


    Scoring Help

    Scoring Help: Case Scenarios
    The physical therapist's clinical judgment is critical in selecting the appropriate severity modifier. PTNow's co-chairs and APTA's program director for quality have created multiple case scenarios in a variety of formats to help guide you through the process.

    Lists of Identified Tests & Measures

    • Tests and measures are listed alphabetically and are grouped by section or EDGE taskforce.
    • Links to actual tests are provided as APTA obtains the licensing to post them.
    • Asterisks denote tests that are primary examples (but only examples) for reporting the domain of interest.
    • The listing of a test on PTNow does not imply that APTA, APTA sections, or EDGE taskforces endorse the test as the only test that may be used.
    • Tests and measures that were identified by more than one group are bolded.


    Acute Care Section

    Submitted by Cathy Elrod, PT, PhD, on behalf of the section. The full list of identified tests and measures will be posted in mid-May.

     

    Cardiovascular and Pulmonary Section

    Submitted by Daniel Malone, PT, PhD, CCS, on behalf of the section. Selections for July 1 posting will be reported in mid-May.

    Oncology Section 

    2-Minute Walk Test
    5 Times Sit to Stand
    6-Minute Walk Test
    Barthel Index
    Berg Balance Scale
    Brief Fatigue Inventory
    Brief Peripheral Neuropathy Screen
    Brief Pain Inventory
    Borg Rating Scale of Perceived Exertion Scale
    Bruininks-Oseretsky Test of Motor Proficiency
    Dizziness Handicap Inventory Questionnaire
    Disabilities of the Arms, Shoulder, and Hand (DASH)
    Face Pain Scale-Revised
    Functional Assessment of Cancer Therapy-Cognitive Function
    Functional Independence Measure
    Functional Reach
    General Sickness Impact Profile
    Karnofsky Performance Scale
    Medical Research Council Dyspnea scale
    Mini-Mental State Examination
    Modified Total Neuropathy Score
    National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 4.0 (cognitive or concentration scales; dizziness scales; edema, lymph leakage, and lymphedema scales; fall scale; fatigue scale; gait scale; pain scales; peripheral motor neuropathy scale; joint range of motion decreased scales; muscle weakness scales; fibrosis deep connective tissue scale; superficial soft tissue fibrosis scale) 
    Neuropathy Screening Scale
    Numeric Rating Scale
    Peabody Developmental Motor Scale
    Perceived Cognition Questionnaire
    Physical Performance Test
    Piper Fatigue Scale
    Shoulder Pain and Disability Index (SPADI)
    Timed “Up & Go” Test
    Tinetti Balance and Gait Scale
    Reintegration to Normal Living Index
    Visual Analog Scale

    Submitted on behalf of the Oncology Section by Laura S Gilchrist, PT, PhD; Mary Lou Galantino, PT, PhD; Meredith Wampler, PT, DPTSc; Victoria G Marchese, PT, PhD; G Stephen Morris, PT, PhD; Kirsten K Ness, PT, PhD; Pamela K Levangie, PT, DSc; Dave Kietrys, PT, PhD; Marisa Perdomo, PT, DPT; Chris A. Selbelski, PT, DPT; Claire Davies, PT, PhD; and the Oncology Section Board of Directors.

     

    Section on Clinical Electrophysiology and Wound Management

    Information to come.

     

    Section on Geriatrics and Home Health Section

    Submitted by members of the Section on Geriatrics (SOG) Practice Committee, SOG Reimbursement/Federal Affairs Committee, and GeriEDGE Task Force: Dale Avers, PT, DPT, Alice Bell, PT, DPT, GCS, Kevin Chui,PT, DPT, PhD, GCS, OCS, Stacy Fritz, PT, PhD, Jason Hardage, PT, DPT, DScPT, NCS, Greg Hartley, PT, DPT, GCS, Carole Lewis, DPT, PhD, GCS, FAPTA, Michelle Lusardi, PT, DPT, PhD, Kathleen Mangione, PT, PhD, Joe Norman, PT, PhD, CCS, FAACVPR, Mindy O. Renfro, PT, PhD, GCS, CPH, Kathryn E. Roach, PT, PhD, Tiffany Shubert, PT, Veronica Southard, PT, DHSc, GCS, Ellen Strunk, PT, GCS, CEEAA, Dawn Venema, PT.

    Submitted by Kenneth Miller, PT, DPT, CEEAA, on behalf of the Home Health Section, which concurs with this list of selected tests and measures.

     

    Section on Hand Rehabilitation

    Submitted by Cynthia Johnson, PT, PhD, on behalf of the section.

     

    Orthopaedic Section

    Submitted by James J. Irrgang, PT, PhD, ATC, FAPTA, on behalf of the section. Julie Fritz, PT, PhD, OCS, and colleagues at Intermountain Healthcare also contributed.

     

    Section on Women's Health

    • Chronic Prostatitis Symptom Index (NIH-CPSI) Get Test
    • Colorectal Functional Outcome Questionnaire (COREFO)
    • Constipation Scoring System (CSS)
    • Depression, Anxiety, Stress Scale (DASS21) Get Test
    • Fear Avoidance Beliefs Questionnaire (FABQ) Get Test
    • Female Sexual Function Index (FSFI) Get Test
    • Geriatric Self Efficacy Scale for Urinary Incontinence (GSE-UI)
    • Incontinence Impact Questionnaire (IIQ)
    • International Consultation on Incontinence Questionnaire-Bowels (ICIQ-B)
    • Lower Extremity Functional Scale (LEFS) Get Test - Hip Disorders | Get Test - Ankle Disorders | Get Test - Knee Disorders
    • Oswestry Low Back Pain Disability Questionnaire
    • Pain Catastrophizing Scale (PCS) (Centre for Research on Pain, Disability and Social Integration) Get Test
    • Patient-Specific Functional Scale (PSFS) Get Test (TAC Australia)
    • Pelvic Floor Distress Inventory (PFDI) Get Test (Beaumont Health System/Michigan)
    • Pelvic Floor Impact Questionnaire (PFIQ) Get Test (Yale School of Medicine)
    • Pelvic Girdle Pain Questionnaire (PGQ) 
    • Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire (PISQ-12)
    • Short Personal Experience Questionnaire (SPEQ)
    • Tampa Scale for Kinesiophobia (TSK) Get Test (WorkSafe Australia)
    • Urogenital Distress Inventory (UDI)

    Submitted by members of the Women's Health PTNow Task Force for Functional Outcome Measures: Darla Cathcart, MPT, WCS, CLT, Susan Clinton, MHS, PT, OCS, WCS, Secili DeStefano, PT, DPT, OCS, Carol Figuers, PT, EdD, Jennifer Hungate, PT, DPT, WCS, Alaina Newell, PT, DPT, CLT, Jessica Powley, PT, DPT, Joan Quinonez, PT, MPT, CAPP-OB. Selections for July 1 posting will be reported in late May/early June.

     

    Neurology Section

    Multiple Sclerosis Task Force

    Submitted by Multiple Sclerosis Task Force: Kirsten Potter, PT, DPT, MS, NCS, Chair, Diane Allen, PT, PhD, Amy M Yorke, PT, MPT, NCS, Gail Widener, PT, PhD, Susan Bennett, PT, DPT, EdD, NCS, MSCS, Evan Cohen, PT, MA, PhD, NCS, Kathleen Brandfass, MS, PT

     

    PD EDGE (Parkinson Disease)

    • 2-Minute Walk Test
    • 6-Minute Walk Test Get Test - Parkinson Disease
    • 9-Hole Peg Test ** Get Test - Parkinson Disease
    • 10-Meter Walk Test ("Gait Speed") ** Get Test - Parkinson Disease
    • Berg Balance Scale (BBS) ** Get Test - Parkinson Disease
    • BESTest - Brief-BESTest  Get Test
    • BESTest - Mini-BESTest  Get Test (Provided with permission of Fay B. Horak)
    • Continuous Scale of Physical Functional Performance (CS-PFP)
    • Five-Times-Sit-to-Stand
    • Freezing of Gait Questionnaire Get Test
    • Functional Reach Test Get Test
    • Parkinson's Disease Quality of Life Scale - 8-item (PDQ-8)
    • Parkinson's Disease Quality of Life Scale - 39-item (PDQ-39) Get Test
    • Profile PD
    • Tinetti Mobility Test
    • Unified Parkinson's Disease Rating Scale (UPDRS) ** Get Test
    • World Health Organization Quality of Life (WHOQOL)
    • World Health Organization Quality of Life-abbreviated version (WHOQOL-BREF)

    Submitted by PD EDGE: Deb Kegelmeyer PT, DPT, MS, GCS (Chair), Terry Ellis PT, PhD, NCS, Rosemary Gallagher PT, DPT GCS, Alicia Esposito PT, DPT, NCS, Suzanne O'Neal PT, DPT NCS, Cathy C Harro, PT, NCS, Erin Hussey DPT, NCS, Jeffrey Hoder, PT, DPT, NCS

     

    SCI EDGE (Spinal Cord Injury)

    • 6-Minute Walk Test (6MWT)  Get Test - Stroke
    • 10-Meter Walk Test (10MWT) ** Get Test - Spinal Cord Injury
    • Berg Balance Scale (BBS) ** Get Test - Spinal Cord Injury
    • Capabilities of UE Functioning Instrument (CUE) ** Get Test
    • Craig Handicap Assessment and Reporting Technique (CHART)
    • Dynamic Gait Index (DGI) Get Test
    • Functional Independence Measure (FIM)
    • Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP)
    • Life Satisfaction Questionnaire (LiSat-9)
    • Multidimensional Pain Inventory-SCI version
    • Needs Assessment Checklist (NAC)
    • Reintegration to Normal Living (RNL) Index
    • Satisfaction With Life Scale (SWLS) , Deiner Scale
    • Short-Form Health Survey of the Medical Outcome Study (SF36)
    • Sickness Impact Profile 68 (SIP-68)
    • Spinal Cord Independence Measure (SCIM) - SCIM II and SCIM III ** Get Test
    • Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI)
    • Spinal Cord Injury Functional Ambulation Profile (SCI-FAP)
    • Timed "Up and Go" (TUG) Get Test - Parkinson Disease
    • Walking Index for Spinal Cord Injury (WISCI)
    • Walking Index for Spinal Cord Injury (WISCI) - WISCI II
    • Wheelchair Skills Test
    • World Health Organization Quality of Life-abbreviated version (WHOQOL-BREF)

    Submitted by SCI EDGE: Jennifer Kahn, PT, DPT, NCS, (Chair), Christopher Newman, PT, MPT, NCS, Phyllis Palma, PT, DPT, Wendy Romney, PT, DPT, NCS, Rachel Tappan, PT, NCS, Candy Tefertiller, PT, DPT, ATP, NCS, Eileen Tseng, PT, DPT, NCS, Cara Leone Weisbach, PT, DPT

     

    StrokEDGE

    Submitted by StrokEDGE: Beth Crowner, PT, DPT, NCS, Diane Nichols, PT, NCS, Dorian Rose PT, PhD, Rie Yoshida, PT, DPT, Genevieve Pinto Zipp, PT, EdD (Co-chair), Jane E. Sullivan, PT, DHS, (Co-chair)

     

    TBI EDGE (Traumatic Brain Injury)

    • 2-Minute Walk Test
    • 6-Minute Walk Test Get Test - Parkinson Disease
    • 10-Meter Walk Test Get Test - TBI
    • Action Research Arm Test **
    • Activities-specific Balance Confidence Scale (ABC)  Get Test - TBI
    • Assessment of Life Habits
    • Balance Error Scoring System (BESS)
    • Barthel Index Get Test - Older Adults
    • Berg Balance Scale (BBS) Get Test - Parkinson Disease | Get Test - Stroke
    • BESTTest (Balance Evaulation Systems Test) Get Test (Provided with permission of Fay B. Horak)
    • Brunel Balance Assessment
    • Canadian Occupational Performance Measure
    • Clinical Test of Sensory Interaction and Balance (CTSIB)
    • Community Balance and Mobility Scale ** Get Test
    • Dizziness Handicap Inventory  Get Test - TBI
    • Dynamic Gait Index Get Test
    • European Quality of Life (EuroQoL) Questionnaire
    • Four-Square Step Test (FSST)
    • Fullerton Advanced Balance Scale Get Test
    • Function In Sitting Test
    • Functional Ambulation Categories
    • Functional Assessment Measure
    • Functional Gait Assessment (FGA)
    • Functional Independence Measure (FIM)
    • Functional Reach Test Get Test - Parkinson Disease
    • Function Reach Test - Modified
    • Functional Status Examination
    • High-Level Mobility Assessment (HiMAT) ** Get Test
    • Mayo Portland Adaptability Inventory-4 **
    • Participation Assessment with Recombined Tools-Objective
    • Rivermead Mobility Index (RMI)
    • Satisfaction With Life Scale (SWLS)
    • Sensory Organization Test (SOT)
    • Timed "Up and Go" (TUG) Get Test - Parkinson Disease
    • Timed "Up and Go" (TUG)-Cognitive
    • Trunk Control Test
    • Trunk Impairment Scale (TIS)
    • Walking and Remembering Test
    • Walking While Talking Test
    • Wolf Motor Function Test

    Submitted by TBI EDGE: Karen McCulloch, PT, PhD, NCS (Co-Chair), Anna de Joya, PT, DSc, NCS (Co-Chair), Erin Donnelly, PT, MSPT, NCS, Kaitlin Hays, PT, DPT, Tammie Keller Johnson PT, DPT, MS Coby Nirider, PT, DPT, Heidi Roth, PT, DHS, NCS, Sue Saliga, PT, MS, DHSc, Irene Ward, PT, DPT, NCS

     

    Vestibular EDGE

    Submitted by Vestibular EDGE: Matthew Scherer PT, PhD, NCS (Chair), Linda Horn PT, DSciPT, MHS, NCS (Co-Chair), Elizabeth Dannenbaum PT, Jenny Fay PT, DPT, Karen Lambert MPT, NCS, Tracy Rice PT, MPH, NCS, Jennifer Stoskus PT, DPT, Diane Wrisley PT, PhD, NCS

     

    Questions? Contact janreynolds@apta.org.

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