On October 1, 2012, ASCs will be required to start reporting quality data G-codes on five measures (four adverse events and the timing of prophylactic IV antibiotic administration) or face future Medicare payment reductions. ASCs will include the G-code corresponding to the Medicare patient’s experience under the procedure code(s) in box 24 D of the CMS-1500 claim form. Click here for the list of G-codes.
Between October 1 and December 31, 2012, ASCs will be considered successful reporters and not face future financial penalties if 50 percent of their Medicare claims contain quality data G-codes. (This percentage may increase in future years.) In addition, ASCs should include the G-codes only on claims where Medicare is the primary payer.
On January 1, 2013, ASCs should begin placing the G-codes on claims where Medicare is either the primary or secondary payer.
Between July 1 and August 15, 2013, ASCs will be required to go to the CMS QualityNet web site and report their total surgical care volume for selected groups of procedures and whether they used a safe surgery checklist at any time between January 1, 2012, and December 31, 2012. No particular checklist is required. Click here for a list of sample safe surgery checklists.
ASC Quality Reporting Measures Specifications Manual
QualityNet Reference Checklist
Free Quality Reporting Toolkit
Quality Data G-Codes
Safe Surgery Checklist Information
Quality Reporting FAQs
Timeline of Important Dates and Events
2014 Final Rule Quality Reporting FAQs
Sample CMS-1500 Claim Form
QualityNet Reporting Delayed Until At Least July 9
2012 Measures (ASC Focus November/December 2011)