G2211 Question

[12scrapbooker]

I need help with getting the G2211 paid with G0439 - I have tried with Mod 25 on G0439 and without modifier - I'm getting denials from Medicare and Medicare Advantage Plans. Is anyone getting paid for this?

 

[csperoni]

G2211 is an add on code. If the only other service is G0439, you cannot bill G2211 as an add on. You must have an evaluation and management service 99202-99205 or 99211-99215.

https://www.cms.gov/files/document/hcpcs-g2211-faq.pdf

 

[jkyles]

Just adding that it is permissible to report an office E/M visit with G2211 and modifier 25, plus an AWV, or any other covered preventive service, on the same date of service. But as csperoni says, the code only works with an office E/M visit.