G Codes

Our office has been using an e-prescribe program for a couple of months now
but we are just now hearing about "G" codes that must be used when reporting to medicare. Are these G codes supposed to be on our superbills and transmitted with our regular billing? And if so, can we still submit our e-prescribes for the three months we didn't know about the G codes? Thank you!

e-prescribe

A “qualified” e-prescribing system must have been adopted by the prescriber. At least 10% of total Medicare Part B payments must come from list of 33 office-based service codes. Physicians must successfully report that they e-prescribed or attempted to e-prescribe at least 50% of the time during eligible situations
How to report: If you use a qualified e-prescribing system AND, If you use any one of the following codes:
90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, G0101, G0108, G0109
Report one of the following codes:
–G8443: All prescriptions created during the encounter were generated using a qualified e-prescribing system
–G8446: Provider does have access to a qualified e-prescribing system. Some or all prescriptions generated during the encounter were printed or phoned as is required by state or federal law or regulations, patient request or pharmacy system being unable to receive electronic transmission; OR because they were for narcotics or other controlled substances
G8445: No prescriptions were generated during the encounter
No registration is required; you can begin reporting for the bonus at anytime in 2009
You must successfully report one of the three e-Prescribing codes for 50% of the eligible visits during the calendar year
–If you wait until April 1, you will need to report 75% of the time; if you wait until July 1, you will need to report 100% of the time to qualify for the bonus
CMS: www.cms.hhs.gov/PQRI and select “E-Prescribing Incentive Program” in the left-hand column
For audiotapes and slides from October 2008 program hosted by CMS and 34 partner organizations: www.massmed.org/cme/CMS_eprescribing
Check with your Carrier regarding retroactive submission.

G codes and e-prescribing

You can't go back and resubmit, so it makes it very important to begin submitting now, on all of your Medicare claims.

Nancy's answer outlines the program, and there are several articles on Codapedia about the topic:

http://www.codapedia.com/~article_148_.cfm

http://www.codapedia.com/~article_316_.cfm

If you search e-prescribing, you will also find forum posts and information about PQRI and the stimulus package.

In summary....

no, you cannot go back- the code must be reported with the E&M code.

you still have plenty of time to earn the bonus since it requires only 50% of 2009 claims to have the appropriate G code.