| HCPCS Code: |
G0381 |
| Long Description: |
Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
| Short Description: |
Lev 2 hosp type b ed visit |
| Pricing Indicator 1: |
00 (Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)) |
| Multiple Pricing Code: |
9 (Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is 99)) |
| Statute Number: |
|
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
M3 (Emergency room visit) |
| Type of Service Code 1: |
1 (Medical care) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2007 |
| Action Effective Date: |
01-01-2008 |
| Action Code: |
N (No maintenance for this code) |
