Wiki G2211

[desireewhite185@yahoo.com]

Hello,
I was just curious if any of you bill the G2211 add on code. I work in a RHC clinic so I thought we couldn't bill that code. My billing department tells me I can; we most likely won't get paid, but our doctors will get the .33 wRVU. I recently billed it for a visit where the patient is being seen for over active bladder and one for urinary incontinence. I was just curious how often other OB/GYN billers are using this code. Ty!

 

[natashalage]

Hello, I am not an expert or educator and currently, on Sunday, i am on aapc webinar, so i am sorry for my disorganized sentences. At our practice, our providers use G2211 a LOT. We were told not to delete G2211 when a self-coding md drops it. Per my understanding, G2211 is when provider coordinates care for the patient: initiates referals, orders lab, diagnostic studies and Continues seeing the pt and Continues coordinate pt's care for pt's illness. It's like MD is in a center of attention, care, nothing goes without his approval, suggestion etc. There is a special word in the description of this code something like ' longitude.....care". Some of our providers put a separate paragraph that I did, i do, ....

 

[amyjph]

You could add it if the requirements are met and the documentation supports it for the RVU tracking, it just won't be paid outside the encounter rate/bundle as described below. Did the documentation meet the requirements?

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

Q5: Can HCPCS code G2211 be billed in an FQHC or RHC?A: We generally pay Rural Health Clinic (RHC)s and Federally Qualified Health Center (FQHCs) an encounter-based rate. The service described by HCPCS add-on code HCPCS code G2211 is bundled into the RHC all-inclusive rate or FQHC prospective payment system payment rate along with the service described by the O/O E/M base code with which HCPCS code G2211 would be billed.

There is no separate payment made to an FQHC or RHC for HCPCS code G2211.

https://www.aapc.com/blog/91931-bill-g2211-with-confidence-and-modifier-25/?srsltid=AfmBOooL57Hkswe1WXepFIoUiEBGep2W_eewzj9MceK7Im9Kd7WjHZm_

https://www.cms.gov/files/document/mm13473-how-use-office-and-outpatient-evaluation-and-management-visit-complexity-add-code-g2211.pdf

https://www.cms.gov/files/document/mm13272-edits-prevent-payment-g2211-office/outpatient-evaluation-and-management-visit-and-modifier.pdf

https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/evaluation-management/G2211-what-it-is-and-how-to-use-it.html

https://www.aafp.org/pubs/fpm/blogs/gettingpaid/entry/g2211-payment.html

Go here and search G2211: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf#page=40
Helpful flow sheet: https://www.aafp.org/dam/brand/aafp/pubs/fpm/issues/2025/0100/g2211-infographic.pdf