The Latest Headache with Code G2211
On December 5, 2024, National Correct Coding Initiative (NCCI) editing was updated with an error requiring HCPCS G0463 as the primary code for add-on code G2211.
This change error has led to denials for G2211 when billed with CPT office visit codes 99202-99205 and 99211-99215 for any dates of service rendered from 01/01/2024 to 09/30/2024 that were submitted for processing on or after 12/05/2024.
While this NCCI edit has likely impacted all MACs, NGS is currently the only Medicare Administrative Contractor that has provided any information addressing claims denials.
“NGS has reached out to the Centers for Medicare & Medicaid Services (CMS) for guidance on resolving the issue. Providers are advised that the NGS Provider Call Center cannot offer additional information at this time. Updates will be posted on the NGS website as they become available.
No immediate action is required from providers. Monitor NGS communications for updates on this issue and the timeline for resolution. For now, continue standard billing practices while awaiting further instructions.”
Current information being provided is that there is no provider action needed and claims should NOT be resubmitted; CMS will be reprocessing the claims.
In the meantime, if this error impacts any claims for the dates of service 01/01/2024 to 09/30/2024 that you may have submitted on or after 12/05/2024, monitor the claims and any communications from CMS or your regional MAC for additional guidance.