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Primary Care Coding Alert

E-Prescribing:

Here's Your 3-Step Prescription for G8553 Claims Success

Published on Mon May 14, 2012

Check filing dates and charge guidelines to smooth processing every time.

HCPCS doesn't include specific guidelines for reporting G8553, which makes some coders wonder if they're using it correctly. Here's how to know that you're filing correctly, including charging the correct amount and adding the most pertinent details to your claim.

Step 1: Verify G8553 Applies to the Patient

You'll turn to code G8553 (Prescription[s] generated and transmitted via a qualified erx system) when reporting e-prescriptions. Don't automatically report it for any patient your physician orders an e-prescription for, however. Code G8553 only applies to Medicare patients. Add it to your claim anytime the physician e-prescribes a medication for a Medicare patient during a visit with that patient.

Step 2: Include G8553 With Encounter Code

Code G8553 only applies to e-prescriptions ordered during an encounter [...]
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