Clarification Regarding Problems with G-Codes and the Associated Charge

March 29, 2013

Several Medicare quality reporting questions posted recently on ASCA’s online, members-only networking community, ASCA Connect, concern how to report G-codes with no associated charges.

Per the QualityNet web site, quality data G-codes must be entered on the CMS-1500 claim form and have an associated charge in order to be accepted into the CMS warehouse. These codes will populate fields 24 D and 24 F on the CMS-1500 claim form.

  • The submitted charge field cannot be blank.

  • The line-item charge should be the numeral "0" (zero). Please note that dollar signs ($) or decimal points are not accepted.

  • If a system does not allow a zero line-item charge, a nominal amount can be substituted; the beneficiary is not liable for this nominal amount.

  • Entire claims with a zero charge will be rejected. The total charge for the claim cannot be zero.

  • When a zero charge or a nominal amount is submitted to the carrier or contractor, payment for the amount included in the ASC QDC line is denied and tracked.

 

The Centers for Medicare & Medicaid Services (CMS) has designated FMQAI as the ASC Quality Reporting (QR) Program Support Contractor. FMQAI provides technical support and feedback to assist ASCs with quality data reporting.

Questions can be submitted about the ASC QR Program to FMQAI via the QualityNet web site or by calling, toll-free, 866.800.8756 weekdays from 7am to 6pm ET.


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