Number of New Patient and Follow-up Slots

[mdo1738]

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For G2211, are you all billing that on a follow up visit post INJ if the patient reported adequate relief and is not getting any chronic meds besides PRN muscle relaxants. Next visit is in a 3-6 months for re evaluation if another INJ is needed

Yes. You have a longitudinal relationship established with that patient, in which you are managing a complex chronic condition. Your knowledge of what their pain generator is, what their imaging and exam show, what their response to a particular injection you did was, etc, all of these things that come with a longitudinal relationship.

G2211 is very different from the numerical level codes. You don’t have to be doing anything crazy, they don’t have to be on opioids, and their pain can be controlled just fine on whatever plan you have them on, and G code is still justified. It literally just has to be a longitudinal relationship for a complex condition, which chronic pain obv is.

 

[Dr. Ice]

Yes. You have a longitudinal relationship established with that patient, in which you are managing a complex chronic condition. Your knowledge of what their pain generator is, what their imaging and exam show, what their response to a particular injection you did was, etc, all of these things that come with a longitudinal relationship.

G2211 is very different from the numerical level codes. You don’t have to be doing anything crazy, they don’t have to be on opioids, and their pain can be controlled just fine on whatever plan you have them on, and G code is still justified. It literally just has to be a longitudinal relationship for a complex condition, which chronic pain obv is.

So everyone will keep billing this code until it’s worth nothing…nice, sounds like scs

 

[callmeanesthesia]

So everyone will keep billing this code until it’s worth nothing…nice, sounds like scs

CMS intended the code to be used for something like 3/4 of all primary care visits. Our entire specialty using it for every visit wouldn’t even be a blip on that radar.

 

[Dr. Ice]

CMS intended the code to be used for something like 3/4 of all primary care visits. Our entire specialty using it for every visit wouldn’t even be a blip on that radar.

Good to know, I’ll start using it at nauseum starting Monday

 

[MitchLevi]

I could be wrong but isn’t that only a Medicare code?

 

[sloh]

So everyone will keep billing this code until it’s worth nothing…nice, sounds like scs

Eh, CMS usually doesn’t come after you for office/E&M codes

 

[Welcome123]

So everyone will keep billing this code until it’s worth nothing…nice, sounds like scs

payment will decrease/be difficult in the future if it is over utilized or not.
you should maximize payment as appropriate

Sooner or later it will be decreased

 

[Ducttape]

i dont think they will come after this code any time soon.


it is really meant for PCPs and those of us who do a lot of longitudinal care.

and if you think we are being underpaid, dont talk to a PCP...

 

[bedrock]

I could be wrong but isn’t that only a Medicare code?

Anyone have an answer to this question??

 

[callmeanesthesia]

Anyone have an answer to this question??

Medicare and Medicare advantage I think.

 

[GatorCHOMPions]

Anyone have an answer to this question??

At my job we are using it on everyone who qualifies for longitudinal care (minus same day procedure). When it was first rolled out we were told just Medicare but that was a while ago. I'm getting my pellets for it so that's all I care about.

 

[drrosenrosen]

I tried it on everyone (appropriately) for a few months, but never got paid by BCBS, UHC, or Aetna. Only bill it for medicare and advantage now

 

[BobBarker]

I think we have gotten paid on bcbs. Let me look.

 

[BobBarker]

Looks like bcbs allows $20.57.

 

[nvrsumr]

I have a couple insurances that kicked back as a patient responsibility which I then wrote off

 

[SgtThunderfistMD]

i dont think they will come after this code any time soon.


it is really meant for PCPs and those of us who do a lot of longitudinal care.

and if you think we are being underpaid, dont talk to a PCP...

PCP's can't use it

 

[Ducttape]

G2211 Add-on Code: What It Is and How to Use It

The care you provide your patients is complex and comprehensive. G2211 will help you get paid more accurately for it.

www.aafp.org

The Centers for Medicare & Medicaid Services (CMS) created code G2211 to better account for the resource costs associated with visit complexity inherent to primary care and other longitudinal care.

and directly from CMS:

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

 

[Nargosi]

PCP's can't use it

That is very incorrect

 

[BobBarker]

They can and should use it. Many of them don’t seem to know anything about billing or care to learn. I have seen level 3 follow up visits many, many times where they refilled 5 medications and made two referrals.

 

[BobBarker]

There was an older pcp who routinely no charged opioid med refills even though the patient came into the office. Even if the patient was Medicare/medicaid dual coverage.