G0380 HCPCS - LEVEL 1 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)

Code Information

HCPCS Code: G0380

Sequence Number: 0010

Short Description: Lev 1 hosp type b ed visit

Long Description: Level 1 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)

Code Added Date: 1/1/2007

Action Code: N - No maintenance for this code

Action Effective Date: 1/1/2008

Classification: Temporary Procedures & Professional Services

Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: M3 - Emergency room visit
Type Of Service Code:
  • 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96

Billing Information

Pricing Indicator Code:
  • 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator Code: 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Coverage Issues Manual Reference Section Number:
    N/A
    Medicare Carriers Manual Reference Section Number:
      N/A
      Coverage Code: C - Carrier judgment

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code G0380
      HCPCS Sequence Number 0010
      HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
      HCPCS Long Description Level 1 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)
      HCPCS Short Description Lev 1 hosp type b ed visit
      HCPCS Pricing Indicator Code 1 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
      HCPCS Multiple Pricing Indicator Code 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
      HCPCS Coverage Code C - Carrier judgment
      HCPCS Berenson-Eggers Type Of Service Code M3 - Emergency room visit
      HCPCS Type Of Service Code 1 1 - Whole blood only eff 01/96, whole blood or packed red cells before 01/96
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 1/1/2007
      HCPCS Action Effective Date 1/1/2008
      HCPCS Action Code N - No maintenance for this code

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      This page was last updated on: 1/1/2018