Part B Insider (Multispecialty) Coding Alert

Published on Thu Jan 01, 2009 PDF

Three G codes could help you tell your payer why you deserve a bonus for your e-prescribing efforts.

Question: Our practice members are looking forward to using e-prescribing as soon as our system is set up. Which codes should we report to qualify for the e-prescribing bonus?

Answer: Physicians who adopt e-prescription systems are eligible to earn a bonus of two percent of their total Medicare allowed charges. The physician does not have to register to be considered for the two percent bonus from e-prescribing. The physician must report e-prescription activity on 50 percent of the Medicare patients he sees. Reporting includes three G codes, which indicate one of three conditions:

• G8443 -- All prescriptions created during the encounter were generated using a qualified e-prescribing system

• G8445 -- No prescriptions were generated during the encounter, provider does have access to a qualified e-prescribing system

• G8446 -- Provider does have access to a qualified e-prescribing system and some or all prescriptions generated during the encounter were printed or phoned in as required by state or federal law or regulations, patient request, or pharmacy system being unable to receive electronic transmission; OR because they were for narcotics or other controlled substances.

Medicare is offering the bonus because "E-prescribing can greatly reduce the number of medication errors that jeopardize the health and safety of Medicare patients and waste precious health care dollars treating conditions that never should have happened," according to CMS Acting Administrator Kerry Weems.

You can find more information about e-prescribing and the accompanying bonus on the CMS Web site at http://www.cms.hhs.gov/PQRI/Downloads/E-prescribingMeasureSpecifications.pdf.