Federal Regulations

Quality Reporting G-Codes

Beginning on October 1, 2012, ASCs will be required to start reporting quality data G-codes on five measures 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.

The number of G-codes reported on the claim form will always be either two or five:

One G-code that corresponds to the patient’s experience with prophylactic IV antibiotic will be reported on all claims.
An additional G-code, G-8907, will be reported if the patient does not experience any of the four specific adverse events (patient burn, patient fall, wrong site/side/patient/procedure/implant and hospital transfer/admission).
An additional four G-codes, each corresponding to one of the four specific adverse events, will be reported if the patient does experience one or more of the adverse events.

ASCs that experience problems with using these codes should email ASCA.

Download a G-codes Cheat Sheet

Download a Sample CMS-1500 Claim Form

Corresponding Quality Measure	G-code	Description
All	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 hospital admission upon discharge from the facility.
Patient burn	G8908	Patient documented to have received a burn prior to discharge
Patient burn	G8909	Patient documented not to have received a burn prior to discharge
Patient fall in ASC facility	G8910	Patient documented to have experienced a fall within the ASC
Patient fall in ASC facility	G8911	Patient documented not to have experienced a fall within the ASC
Wrong site, wrong side, wrong patient, wrong procedure, wrong implant	G8912	Patient documented to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
Wrong site, wrong side, wrong patient, wrong procedure, wrong implant	G8913	Patient documented not to have experienced a wrong site, wrong side, wrong patient, wrong procedure or wrong implant event
Hospital transfer/Admission	G8914	Patient documented to have experienced a hospital transfer or hospital admission upon discharge from ASC
Hospital transfer/Admission	G8915	Patient documented not to have experienced a hospital transfer or hospital admission upon discharge from ASC
Timing of Prophylactic Antibiotic Administration	G8916	Patient with preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, antibiotic initiated on time
Timing of Prophylactic IV Antibiotic Administration	G8917	Patient with preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, antibiotic not initiated on time
Timing of Prophylactic IV Antibiotic Administration	G8918	Patient without preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis

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Phone: 703.836.8808 • Fax: 703.549.0976 • asc@ascassociation.org

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