Wiki G2211

[KoBee]

There seems to be a lot of confusion or interpretation on when to code for G2211. I interpret G2211 cannot be coded without its based code 99202-99215 and use of modifier 25 is used. Is this incorrect?

If a provider sees a patient for their annual wellness visit, depression screening and patient requires additional evaluation and management (99202-99215) of a new, existing, or worsening health problem. G2211 is allowed?

If a pediatric sees a patient for their annual physical and only gets routine immunizations, G2211 is not allowed?

Help :/

 

[jkyles]

Hi there - yes it is an add-on code that currently can only be reported with the office/other outpatient codes. However, you will not append modifier 25 to the primary code unless you're also reporting a covered preventive service on the same day.

Here's some info from CMS. There's a link to the list of covered preventive services in the document. https://www.cms.gov/files/document/...anagement-visit-complexity-add-code-g2211.pdf

Keep in mind that G2211 indicates one of the following:

1. The provider is the continuing focal point for all needed services, like a primary care practitioner. OR
2. The provider giving ongoing care for a single, serious condition or a complex condition.