Wiki Quality Reporting G Codes for an ASC


Mount Dora, FL
Best answers
Hi ASC coders!
I have loaded the new ASC quality reporting G-codes for medicare. I entered the codes that my facility would use.

G8907: [Patient documented not to have experienced any of the following events; a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or admission upon discharge from the facility]
G8914: [Patient documented to have experienced a hospital transfer or admission upon dishcarge from ASC]
G8915: [Patient documented NOTto have experenced a hospital transfer or admission upon discharge from the facility
I want to start testing these codes out and have a question. I am confused about the G8907 and the G8915. Do I use both codes or just one? It seems silly to have created the G8915 if the G8907 covers that data of reporting.

Has anyone else starting to use these too? Any feed back is appreciated.
Thanks, Andrea
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We have not started working with these codes yet, but to my understanding if everything was a no then the G8907 would be reported.
You only need to use G8907. Also don't forget about G8916, G8917, G8918. I started using them on April 1st claims. Mostly we are using G8907 and G8916 at this point. I have not heard anything or gotten any responses on these claims yet, so waiting patiently.
Thanks for the input bdobyns & dstruve. I only loaded the G codes that we would use, we do not use any prophylactic's here........but for arguments sake just say we did.....patient had no issues and was also given the IV antibiotic for SSI on time.....would you code both the G8907 & G8916 on the same claim? It just seems like a lot more code lines on a claim. I sent a few out to Medicare and I'm waiting for the results. I just dont want to be *dinged* for not capturing ALL the quality codes required.
I just heard about these codes. Where are they reported? On the same line as the procedure code or is there a special box for them? Also are they for all providers or just Medicare? Thanks for any help.
Use both the G8907 and G8916. It is a lot of lines but you have to report both.

They are listed on the the claim just like you would any procedure code. They are just for Medicare at this point.
I seen a letter while back stating start using these codes not till Oct 1, 2012, so when is the correct date to use ? Do we use these codes on the claim forms when we send to Medicare?, what about other payors ?
Diagnosis codes

When you are reporting the G codes are you using a specific ICD-9 code or are you using the ICD-9 code for the surgical diagnois?

Thanks for your help!
I am using the diagnosis pointers for the surgical procedure. So far my testing of these codes are good. I figure if I get myself into the habit of using them now before the start date I won't having anything to worry about.
Thank you so much for your response. We are going to start testing soon and that was my only holdup!!

Thanks again,
_UPDATE 6-15-2012_______________________________________

Medicare Quality Reporting Alert: Change in G-code Reporting
ASCA has learned from the Centers for Medicare & Medicaid Services (CMS) that ASCs should not use the quality data G-codes on claims where Medicare is the secondary payer until January 1, 2013.

Beginning October 1, 2012, ASCs must include these codes only on claims where Medicare is the primary payer. Effective January 1, 2013, the quality data G-codes should be placed on claims where Medicare is either the primary or secondary payer.

Originally, CMS had indicated that the quality data G-codes should be included on all Medicare claims beginning October 1, 2012. This policy was revised when CMS discovered that the private insurers acting as the primary payers will not be capable of accepting the new quality data G-codes until January 1, 2013. CMS has indicated that it will soon be officially releasing information on this policy change.

For more information, contact Jonathan Beal at
registering for the reporting of quality G codes

i code for an ASC and our office manager has made several attempts to get our facilty registered so that we may begin reporting but for some reason she is unable to get us registered. When going to the website there doesn't seem to be a dropdown to register, just gives us the general information. Any suggestions?

Thank you
registering with QualityNet

The website we are attempting to register our facility with is QualityNet. We are ready to begin reporting the G codes on our claims but we are unable to accomplish the registration. Any input.

Thank you