Wiki G2212 in 2024

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Cheezum51

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I'll throw this out again. Does anyone know how the time to code the G2212 will be calculated in 2024 when a provider has qualified to use a 992x5 code, based upon time, in 2024? Will it calculate the same as 99417 or differently?

Tom Cheezum, OD, CPC, COPC
 
I have a significant amount of hate for that code. Yes, it calculates differently. Hopefully, this will help:
99417 is calculated from the base time of the primary code. i.e., 99205 is for time of 60 minutes. 15 minutes greater than the 60 minute base qualifies the use of 99417. Any part of 15 minutes in excess of the minimum time qualifies to bill a unit of 99417.

G2212 is calculated from the base time PLUS the minimum time for the prolonged services. i.e., 99205 is for a time of 60 minutes. Once the time documented reaches 74 minutes, then for each 15 minute mark beyond that time - 89 minutes, in this case - then a unit of G2212 may be billed. A complete 15 minutes (89 minutes, 104 minutes, etc) must be completed to be able to bill each unit of G2212.

I hope that helps.
 
jkyles said:
Hi there, you should continue follow the threshold times for G2212 that CMS published in 100-04, chap 12 sec. 30.6.15.2. www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf
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That's for 2023. I want to see if that carries over to 2024.

Assuming that what Lee Jager says does apply to 2024, nothing really changes. Basically, the provider needs to spend at least 30 minutes beyond the minimum time for the 992x5 codes in order to bill the first unit of the G2212.

I would still like to see a reference from CMS regarding this issue for 2024.

Tom Cheezum, OD, CPC, COPC
 
The dates for IOM sections stay the same until CMS makes a change to the section.
 
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