Proper reporting of condition code G0
Hospitals should report condition code G0 (zero) in form locators 24-30 on the UB-04 claim form, the electronic equivalent, when multiple medical visits occur on the same day in the same revenue center, but the visits were distinct and independent visits.
Example
Beneficiary presents to the emergency room (ER) in the morning for a broken arm, then later that same day presents for chest pain.
On the first claim, report the first ER visit (revenue code 045X plus evaluation and management [E/M] code) with all ancillary services rendered on that day.
On the second claim, report only the unrelated ER visit (revenue code 045X plus E/M code) with condition code G0 and modifier 27. All other charges are reported on the first claim.
Proper reporting of condition code G0 allows for proper payment under the Outpatient Prospective Payment System. The Outpatient Code Editor contains an edit that will reject multiple medical visits on the same day with the same revenue code without the presence of condition code G0.
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