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Anyone using/going to use this underwhelming but overly touted code to make another $16?
Add on code for visit complexity. Mainly intended to boost up primary care but I’m pretty sure most of our patients will qualify.Can someone explain what this code is?
No. it’s an add-on code that can be billed with E&M visits. Also says it shouldn’t be billed with codes with a 25 modifier.This can be used for clinic visits and procedures?
I code a level 4 for initial.Hm. I’m definitely interested in this.
I bill a level 4 for most visits unless the patient is doing well.
We all have those patients that suck out our soul and put us behind.
I wonder if a level 4 + this code would be more or less risky to bill than a level 5?
Based on what I read all our patients essentially qualify for this code?Hm. I’m definitely interested in this.
I bill a level 4 for most visits unless the patient is doing well.
We all have those patients that suck out our soul and put us behind.
I wonder if a level 4 + this code would be more or less risky to bill than a level 5?
I code a level 4 for initial.
But ever since I started using Marinol, all my follow ups are super easy. (I know, I know..you all hate Marinol for pain).
Me: How's it going since we started the Marinol
Them: Great! It is really helpful
Me: any side effects?
Them: Nope
Me: Are you getting drowsy or feel "stoned"
Them: Nope. Not at all. It does help me sleep however. I haven't slept this good in a long time. Thanks doc
Me: Do you need more?
Them: Nope
Do you need less?
Them: nope
Me: Alright - see you in 3 months.
Yes I have to code. It’s dumb since it really means nothing. Someone somewhere supposedly uses the data for productivity.LOL
How effective is Marinol for pain ? What kind of pain?
Do you bill for level 3, 4 etc in the military? I thought it was straight salary?
It's an add-on code, billed in addition to the usual 3/4Why would you use this instead of just increasing from a level 3 to a level 4 or 4 to 5?
This sounds like chronic opioid management would fit this to me..."Example 2: In the context of specialty care, HCPCS code G2211 could recognize the resources inherent in engaging the patient in a continuous and active collaborative plan of care related to an identified health condition the management of which requires the direction of a clinician with specialized clinical knowledge, skill and experience. Such collaborative care includes patient education, expectations and responsibilities, shared decision-making around therapeutic goals, and shared commitments to achieve those goals."
Could probably template some of this language to add some garbage to your note for billing purposes, if you were so inclined.
Yes so instead of billing a level 3 with this add on code just bill a level 4. Does that make senseIt's an add-on code, billed in addition to the usual 3/4
A 3's a 3, 4's a 4. Add this to whicheverYes so instead of billing a level 3 with this add on code just bill a level 4. Does that make sense
Didn’t answer my questionA 3's a 3, 4's a 4. Add this to whichever
If your billing note meets level 3 complexity, you bill 99213 plus G2211. If it meets level 4 requirements, you bill 99214 plus G2211. It’s a bonus payment for the added work of a longitudinal relationship.Didn’t answer my question
Don’t get it. So if you see the patient back for fu (longitudinal) you can bill this? Seems stupid but hey if they want to pay more that’s coolIf your billing note meets level 3 complexity, you bill 99213 plus G2211. If it meets level 4 requirements, you bill 99214 plus G2211. It’s a bonus payment for the added work of a longitudinal relationship.
That’s exactly it. I think you can bill it on new patient visits too. Anything that’s a single serious condition or complex chronic condition. So, most of our Medicare patients. Get paid $16 more or whatever it is for the same visit you were doing. Don’t worry, I’m sure they’ll make up for it by cutting procedural reimbursement.Don’t get it. So if you see the patient back for fu (longitudinal) you can bill this? Seems stupid but hey if they want to pay more that’s cool
I have started billing it for HMO's, Medicaid, and Tricare. I was told by my billing company NOT to use it for PPOs. No claims have been processed yet so we'll see how it goes.Can you use this code on non-Medicare patients as well?
it's our genius govt at workI’m a little confused.
Like someone suggested if we throw in some key words about natural supplements, expectations, shared decision making, and shared responsibilities then it qualifies?
Any idea what they define as a longitudinal relationship?If your billing note meets level 3 complexity, you bill 99213 plus G2211. If it meets level 4 requirements, you bill 99214 plus G2211. It’s a bonus payment for the added work of a longitudinal relationship.
I've started doing this for all my med management followups. I'm doing for all payors and will see what happens regarding whether this code is getting paid or not. We made this dot phrase to add language from the CMS documentation:
This patient is being managed for a complex and serious condition that requires ongoing, intensive medical management. The nature of this condition demands constant vigilance and a nuanced approach to treatment. The seriousness of the condition necessitates an in-depth and focused approach to management, including regular monitoring and potential coordination with other healthcare professionals.
Detailed Description of Visit Complexity: This visit involved an intricate evaluation and management of the patient's condition. The complexity of the visit was due to the need for a detailed assessment of the current state, consideration of potential complications, and a careful balancing of treatment options to manage the condition effectively.
Patient's Health Status and History: This patient has a significant pain history which requires regular and detailed management. The condition's impact on their life and health is substantial, necessitating a comprehensive and tailored approach to care.
Do you put all 3 paragraphs in each visit?? Very nice and detailed.I've started doing this for all my med management followups. I'm doing for all payors and will see what happens regarding whether this code is getting paid or not. We made this dot phrase to add language from the CMS documentation:
This patient is being managed for a complex and serious condition that requires ongoing, intensive medical management. The nature of this condition demands constant vigilance and a nuanced approach to treatment. The seriousness of the condition necessitates an in-depth and focused approach to management, including regular monitoring and potential coordination with other healthcare professionals.
Detailed Description of Visit Complexity: This visit involved an intricate evaluation and management of the patient's condition. The complexity of the visit was due to the need for a detailed assessment of the current state, consideration of potential complications, and a careful balancing of treatment options to manage the condition effectively.
Patient's Health Status and History: This patient has a significant pain history which requires regular and detailed management. The condition's impact on their life and health is substantial, necessitating a comprehensive and tailored approach to care.
I stole it, made a dot phrase and have put the whole thing in 4 visits from today that I felt were appropriate.Do you put all 3 paragraphs in each visit?? Very nice and detailed.
Where in the note do you add this verbiage. Is it under a specific ICD10?I've started doing this for all my med management followups. I'm doing for all payors and will see what happens regarding whether this code is getting paid or not. We made this dot phrase to add language from the CMS documentation:
This patient is being managed for a complex and serious condition that requires ongoing, intensive medical management. The nature of this condition demands constant vigilance and a nuanced approach to treatment. The seriousness of the condition necessitates an in-depth and focused approach to management, including regular monitoring and potential coordination with other healthcare professionals.
Detailed Description of Visit Complexity: This visit involved an intricate evaluation and management of the patient's condition. The complexity of the visit was due to the need for a detailed assessment of the current state, consideration of potential complications, and a careful balancing of treatment options to manage the condition effectively.
Patient's Health Status and History: This patient has a significant pain history which requires regular and detailed management. The condition's impact on their life and health is substantial, necessitating a comprehensive and tailored approach to care.
This can work for G3002 as wellI've started doing this for all my med management followups. I'm doing for all payors and will see what happens regarding whether this code is getting paid or not. We made this dot phrase to add language from the CMS documentation:
This patient is being managed for a complex and serious condition that requires ongoing, intensive medical management. The nature of this condition demands constant vigilance and a nuanced approach to treatment. The seriousness of the condition necessitates an in-depth and focused approach to management, including regular monitoring and potential coordination with other healthcare professionals.
Detailed Description of Visit Complexity: This visit involved an intricate evaluation and management of the patient's condition. The complexity of the visit was due to the need for a detailed assessment of the current state, consideration of potential complications, and a careful balancing of treatment options to manage the condition effectively.
Patient's Health Status and History: This patient has a significant pain history which requires regular and detailed management. The condition's impact on their life and health is substantial, necessitating a comprehensive and tailored approach to care.
Are you billing for G3002? My interpretation was this is really basically only useful for PCPs as they manage pain separately from E/M code. Can't count same work twice (once for G3002 and once for E/M).This can work for G3002 as well
Its not limited to primary care. If you read the description of code ANY provider that provides chronic pain management can bill this.Are you billing for G3002? My interpretation was this is really basically only useful for PCPs as they manage pain separately from E/M code. Can't count same work twice (once for G3002 and once for E/M).
I don't think you understood my message. I didn't say it can only be used by primary care. I said it's really only useful for primary because billing the code by itself for pain management pays less than the E/M. And you can't bill the G code and E/M code both together for pain management because you are counting the work twice.Its not limited to primary care. If you read the description of code ANY provider that provides chronic pain management can bill this.
Add on code. Theoretically 16-18 bucks depending on locality per the CMS calculator (Overview of the Medicare Physician Fee Schedule Search | CMS)how much extra is one getting reimbursed for using this code - since apparently you cant use in addition to the baseline E/M code?
Wrong! I am getting paid for both. E/M based on medical decision making.I don't think you understood my message. I didn't say it can only be used by primary care. I said it's really only useful for primary because billing the code by itself for pain management pays less than the E/M. And you can't bill the G code and E/M code both together for pain management because you are counting the work twice.
You are getting paid for both, but if you are audited I don't think you will pass. "a patient can receive an E/M service on the same day as the chronic pain management service, but there must be no overlay between the two services." You are double-dipping.Wrong! I am getting paid for both. E/M based on medical decision making.
You are getting paid for both, but if you are audited I don't think you will pass. "a patient can receive an E/M service on the same day as the chronic pain management service, but there must be no overlay between the two services." You are double-dipping.
I'm getting it independently audited. Will update when I have more infoI don’t know, the phrase “overall treatment management” sounds pretty all encompassing for anything pain related.
The intention is if a pcp is managing your HTN, DM, CAD and then after doing all that, start discussing pain. Clearly distinctly different services.
Trust me, I would love nothing more than to get an extra $70-80 on top of the pathetic e/m payment, but I don’t know if this is medicares intention = potential failed audit.