Wiki G2211 description on patient statements

[Courtcle]

Good morning!

Our EMR system won't let us put the entire official HCPCS description in our system so I wanted to see what everyone else is using. We have patients calling us about what the code is on their statement (Medicare cost-sharing, etc.) and are trying to find different verbiage that will make more sense to both the provider and patient.

Thanks in advance.
Courtney Clement

 

[Cynthia Hughes]

I don't work directly with practices and I have not seen any messaging from Medicare to beneficiaries to explain the new charge. The short descriptor from CMS is "Complex e/m visit add on." However, you might consider something like, "Longitudinal care resource add-on" as the term "complex" might be misunderstood as care for a complex condition when it is actually describing the complexity of providing a visit that is intended to establish or continue a longitudinal patient/physician relationship.

It might be beneficial for the practice administrators to develop a message to patients about the new charge so that it is not a surprise and to provide staff with talking points when patients call with questions. The 2024 MPFS includes some good background that could be used (eg, CMS said, "While we adopted the AMA RUC recommendations for the revised O/O E/M CPT visit codes, those values did not fully account for the resource costs associated with primary care and other longitudinal care of complex patients." and "We reiterated our belief that the O/O E/M visit complexity add-on reflects the time, intensity, and PE resources involved when practitioners furnish the kinds of O/O E/M office visit services that enable them to build longitudinal relationships with all patients (that is, not only those patients who have a chronic condition or single high-risk disease) and to address the majority of a patient's health care needs with consistency and continuity over longer periods of time.").

Will be interested to see what others are using.

I hope that helps.
Cindy

 

[Courtcle]

I don't work directly with practices and I have not seen any messaging from Medicare to beneficiaries to explain the new charge. The short descriptor from CMS is "Complex e/m visit add on." However, you might consider something like, "Longitudinal care resource add-on" as the term "complex" might be misunderstood as care for a complex condition when it is actually describing the complexity of providing a visit that is intended to establish or continue a longitudinal patient/physician relationship.

It might be beneficial for the practice administrators to develop a message to patients about the new charge so that it is not a surprise and to provide staff with talking points when patients call with questions. The 2024 MPFS includes some good background that could be used (eg, CMS said, "While we adopted the AMA RUC recommendations for the revised O/O E/M CPT visit codes, those values did not fully account for the resource costs associated with primary care and other longitudinal care of complex patients." and "We reiterated our belief that the O/O E/M visit complexity add-on reflects the time, intensity, and PE resources involved when practitioners furnish the kinds of O/O E/M office visit services that enable them to build longitudinal relationships with all patients (that is, not only those patients who have a chronic condition or single high-risk disease) and to address the majority of a patient's health care needs with consistency and continuity over longer periods of time.").

Will be interested to see what others are using.

I hope that helps.
Cindy

I appreciate your response. I've reviewed so much information from Medicare, other resources, etc. that I feel like I've been too in the weeds to answer my own question. Thank you!

 

[CathCoding]

Hello ~ We are also having issues explaining this to the patients since it being questioned on their statement. Being the 1st of the year it is possibly being applied to their deductible/co-ins and we are struggling on the scripting for our customer service representatives. Anyone else finding or have a good script they are using and would be willing to share?

I would truly appreciate any guidance. Thank you!!!