Wiki G2211

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KoBee

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Is G2211 only allowed to be coded and billed to Medicare?
 
sorry, I am not an expert but at our multi specialty pro fee organization we are billing G2211 to any payer without restrictions. We were given the criteria that it has to meet but I cannot recall any restrictions with a type of payer.
 
G2211 may be billed to any carrier, and it is not incorrect coding to use it. HOWEVER, some commercial carriers may have a policy that bundles it with the E&M service. That does not mean it was not appropriate to code. We bill to all payors.
 
Can you tell me if we are supposed to build the G2211 to split for provider base billing like we do the E/M codes
 
csperoni said:
G2211 may be billed to any carrier, and it is not incorrect coding to use it. HOWEVER, some commercial carriers may have a policy that bundles it with the E&M service. That does not mean it was not appropriate to code. We bill to all payors.
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I agree. I work with a pediatric multi-specialty group and a couple of our specialties use it and we've only had issues with a couple of payers who are bundling it into the E/M. It is low reimbursement for those that do pay.
 
SSweetland said:
Can you tell me if we are supposed to build the G2211 to split for provider base billing like we do the E/M codes
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Hi there, I think I can answer this question if you can give a little more detail. What do you mean by "split for provider base billing"?
 
To my knowledge, apart from Original Medicare, these insurances cover payment for G2211:
  • Aetna (Medicare Advantage)
  • Anthem (Medicare Advantage)
  • Cigna (Medicare Advantage)
  • Humana (both Commercial and Medicare Advantage)
  • UnitedHealthcare (Medicare Advantage)
You should check the payment policy of your specific insurance provider for more details.
 
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