The December 2023 ACR guidance on how to report the new add-on code G2211 has now been updated to reflect that G2211 is appropriate to bill for an evaluation and management (E/M) visit related to a transient or temporary problem (e.g., sinus congestion) when there is an established relationship for ongoing longitudinal care, even if the ongoing care is unrelated to the transient problem being treated. CMS guidance indicates that transient problems, such as sinus congestion diagnosis, can be billed with G2211 and that the complexity in the add-on code is not in the congestion but is mainly in the cognitive care of the continued responsibility of being the focal point for all needed services for the patient.
Coding example:
An established patient with granulomatosis with polyangiitis (GPA) presents to the office for a follow-up and complains of sinus congestion lasting for the past three days. The provider evaluates the patient and recommends antibiotics to treat any infection. This is communicated with the patient, along with additional precautions due to their immune suppression. This E/M visit should be billed with the add-on code G2211 for their GPA and sinus congestion diagnoses. There is important cognitive effort in the longitudinal doctor-patient relationship with the current diagnosis and the patient’s long-term treatment plan, making the visit inherently complex.
Lunch-and-learn
Additionally, the ACR practice management department is offering a one-hour lunch-and-learn series on “Coding and Billing Guidance for G2211.” This expert-led training will provide step-by-step education and guidance for ACR members and their staff on correctly coding, billing and documenting E/M visits with the add-on code G2211 to maximize reimbursements and minimize claim denials or rejections. To schedule a lunch-and-learn training session, contact Melesia Tillman at [email protected].
For additional questions on billing and coding for G2211, contact the ACR practice management department at [email protected].
