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How do I bill G8553?

Marina Posted Thu 19th of April, 2012 16:32:51 PM

When using escripts with Medicare, I understand that we have to bill with cpt code G8553. Is there a specific dx I need to use with this code and what charge amount do I use for code G8553?

SuperCoder Answered Thu 19th of April, 2012 16:53:30 PM

You can submit G8553 (At least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx system) for the same patient at every encounter during which the provider generates an e-prescription. Because of this, you can meet e-prescribing criteria even if you have a small Medicare population, because you can submit G8553 more than once for each patient.

Remember: Some coders also have questions about whether the e-script is only valid when sent while the patient is still in your office. That detail doesn’t matter, as long as you send the e-script as a direct result of the office visit and the provider’s documentation supports the work.

For more information on the use of G8553 and how to get started with Medicare’s e-prescribing incentive program, be sure to visit the Centers for Medicare and Medicaid Services’ web site at

All you need to do is add the G8553 on each person where you send at least one script via eRx. The rebate is on all your Medicare pts. You don't need a specific ICD9 code, but it is specific to E&M codes - office visits are all included.

Marina Posted Thu 19th of April, 2012 18:30:03 PM

Do I need to put an amount charged or can I bill it with a zero charge?

SuperCoder Answered Thu 19th of April, 2012 19:21:26 PM

With a charge of zero dollars ($0.00) or if your billing system/clearinghouse require an amount of more than zero with a nominal amount (e.g., $0.01) that will be denied

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