HCPCS Code G0383

Official Description

Level 4 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 Descr	Lev 4 hosp type b ed visit
Coverage	Carrier Priced
Pricing Indicator(s)	00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI	9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
BETOS	M3 –
TOS Code(s)	1 – Medical care
Added Date	1/1/2007
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Hospital Part B Services That May Be Paid Through a Comprehensive APC
MUE	0
MUE	Not applicable/unspecified.
OTS Orthotic	No
CCS Clinical Classification	227 - Other diagnostic procedures (interview, evaluation, consultation)

CQ	Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
GP	Services delivered under an outpatient physical therapy plan of care
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit