As ambulatory surgery centers start reporting Medicare quality on Oct. 1, 2012, they are taking on a new responsibility. Staffs are now expected to report G codes on a few outcomes and process of care – a list that will be expanded later on. ASCs that fail to report G codes on a minimum number of Medicare claims will face a financial penalty of 2% of the Medicare payments starting in 2014. 

To be successful with this new duty, staff will have to learn how to select the correct G codes and keep on top of Medicare cases to make sure the right G codes are reported. Since this is a new function, you will need to designate which personnel in your facility will report the G codes. 

G codes: the basics   

A total of 12 G codes cover five claims-based measures. In addition to one process-of-care measure – administration of IV antibiotics – there are four adverse outcomes to report: patient burn, patient fall, transfer to the hospital and wrong site, wrong side, wrong patient, wrong procedure or wrong implant.

When you report G codes, you will need to use at least two per case. Typically, you will be using G 8907, to indicate that none of the four adverse events occurred, and then you will need to choose a second code covering use of the prophylactic IV antibiotic. You will be choosing from among three possibilities – G 8916, 8917 or 8918 – indicating that the antibiotic was given on time, not given on time or not given at all.