How To Use HCPCS Code G0382

HCPCS code G0382 describes a level 3 hospital emergency department visit provided in a type B emergency department. This code is used to identify a specific type of emergency department visit that meets certain requirements. In this article, we will explore the details of HCPCS code G0382, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G0382?

HCPCS code G0382 is a specific code used to identify a level 3 hospital emergency department visit provided in a type B emergency department. It is important to note that this code is only applicable to emergency department visits that meet specific requirements, as outlined in the official description.

2. Official Description

The official description of HCPCS code G0382 is as follows: “Level 3 hospital emergency department visit provided in a type B emergency department.” The short description for this code is “Lev 3 hosp type B ED visit.”

3. Procedure

1. Upon arrival at the emergency department, the patient’s condition and symptoms are assessed by the healthcare provider.
2. The healthcare provider performs a thorough examination and evaluation of the patient’s medical history.
3. Based on the assessment and evaluation, the healthcare provider determines the appropriate level of care required for the patient.
4. Treatment and interventions are provided to address the patient’s medical condition.
5. Documentation of the visit, including the patient’s symptoms, examination findings, and treatment provided, is recorded.
6. Any necessary diagnostic tests or procedures are ordered and performed.
7. After the necessary care has been provided, the patient may be discharged or admitted to the hospital for further treatment.

4. When to use HCPCS code G0382

HCPCS code G0382 should be used when a patient receives a level 3 hospital emergency department visit in a type B emergency department. The emergency department must meet at least one of the following requirements:

• It is licensed by the state in which it is located under applicable state law as an emergency room or emergency department.
• 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.
• 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.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0382, healthcare providers need to ensure proper documentation of the visit. This includes documenting the patient’s symptoms, examination findings, treatment provided, and any diagnostic tests or procedures ordered. It is important to accurately code and bill for the level of care provided during the emergency department visit.

6. Historical Information and Code Maintenance

HCPCS code G0382 was added to the Healthcare Common Procedure Coding System on January 01, 2007. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The code’s pricing indicator code is 00, indicating that the service is not separately priced by Part B.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G0382 may vary. It is important to check with the specific payer for their coverage policies and guidelines. The pricing indicator code for this code is 00, indicating that the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G0382 should be billed:

1. A patient arrives at a type B emergency department with severe abdominal pain. After evaluation and treatment, the patient is discharged with a diagnosis of gastritis.
2. A patient presents to a type B emergency department with a deep laceration on their arm. The healthcare provider stitches the wound and provides appropriate wound care instructions before discharging the patient.
3. An individual experiences chest pain and is taken to a type B emergency department. After evaluation and diagnostic tests, it is determined that the patient is experiencing a heart attack. The patient is admitted to the hospital for further treatment.
4. A patient arrives at a type B emergency department with a high fever and severe cough. The healthcare provider diagnoses the patient with pneumonia and provides appropriate treatment before discharging the patient.
5. An individual sustains a head injury and is brought to a type B emergency department. The healthcare provider performs a thorough examination and orders a CT scan to assess for any internal injuries. The patient is discharged with instructions for monitoring symptoms.