On Oct. 1, 2012, all Medicare-certified ASCs will be required by the new ASC quality reporting program to report quality data G-codes or face payment cuts from Medicare, according to an ASCA Government Affairs Update report.
The quality data G-codes correspond to the occurrence of four adverse events — patient burn, patient fall, wrong site/side/patient/procedure/implant and hospital transfer/admission — and the timing of prophylactic IV antibiotic administration. The G-codes will be located under the procedure codes in box 24 D of the CMS-1500 claim form, according to ASCA.
ASCs will report either two or five G-codes on the claims form, meaning:
• One G-code that corresponds to the patient's experience with prophylactic IV antibiotic administration on all claims.
• An additional G-code (G-8907) if the patient does not experience any of the four adverse events.
• An additional four G-codes, each corresponding to one of the four events, if the patient does experience one or more of the events.
Click here to download ASCA's G-codes cheat sheet.
ASCs must submit at least 50 percent of their Medicare claims with quality data G-codes between Oct. 1 and Dec. 31 to be considered successful reporters. G-codes are only appropriate on claims where Medicare is the primary payor until Jan. 1, 2013, when they are appropriate for claims where Medicare is the primary or secondary payor.
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The quality data G-codes correspond to the occurrence of four adverse events — patient burn, patient fall, wrong site/side/patient/procedure/implant and hospital transfer/admission — and the timing of prophylactic IV antibiotic administration. The G-codes will be located under the procedure codes in box 24 D of the CMS-1500 claim form, according to ASCA.
ASCs will report either two or five G-codes on the claims form, meaning:
• One G-code that corresponds to the patient's experience with prophylactic IV antibiotic administration on all claims.
• An additional G-code (G-8907) if the patient does not experience any of the four adverse events.
• An additional four G-codes, each corresponding to one of the four events, if the patient does experience one or more of the events.
Click here to download ASCA's G-codes cheat sheet.
ASCs must submit at least 50 percent of their Medicare claims with quality data G-codes between Oct. 1 and Dec. 31 to be considered successful reporters. G-codes are only appropriate on claims where Medicare is the primary payor until Jan. 1, 2013, when they are appropriate for claims where Medicare is the primary or secondary payor.
Related Articles on ASC Quality:
California Nurse Ratio Bill Shows Mixed Quality Outcomes
Local Wisconsin Hospital Requires Nursing Bachelor's Degree
8 Babies Exposed to Tuberculosis at California Hospital
