Clarification for G-codes and the associated charge

Several ambulatory surgery center (ASC) leaders have reported questions concerning how to report G-codes with no associated charges, according to the ASC Association (ASCA) web site (www.ascassociation.org).

Per the QualityNet web site (https://www.qualitynet.org), quality data G-codes must be entered on the CMS-1500 claim form and have an associated charge to be accepted into the Centers for Medicare and Medicaid Services (CMS) warehouse. These codes will populate fields 24 D and 24 F on the CMS-1500 claim form, the ASCA says. Consider these other tips:

• 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.

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 (866) 800-8756 weekdays from 7 a.m. to 6 p.m. ET.