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Quality Data G-Codes

ASCs are required to report quality data G-codes on five measures or face Medicare payment reductions. ASCs must 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. ASCs are considered successful reporters on these measures if 50 percent of their Medicare claims during the year contain quality data G-codes. While CMS has indicated that this percentage may increase in future years, for the 2014 reporting period it remains at 50 percent. ASCs must include the G-codes on claims where Medicare is either the primary or secondary payer.

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 Antibiotic Administration G8917 Patient with preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis, antibiotic not initiated on time
Timing of Prophylactic Antibiotic Administration G8918 Patient without preoperative order for IV antibiotic surgical site infection (SSI) prophylaxis