HCPCS Code: |
G0384 |
Long Description: |
Level 5 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 5 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) |