Implement Edits to Prevent Payment of Complexity Add-On Code G2211 When Associated Office/Outpatient Evaluation and Management Visit (Codes 99202-99205, 99211-99215) is Reported With Modifier 25
The purpose of this Change Request (CR) is to provide instructions to the A/B Medicare Administrative Contractors (MACs) to implement edits to deny payment when an associated Office/Outpatient Evaluation and Management (O/O E/M) visit (codes 99202-99205, 99211-99215) is reported with Modifier 25. This edit will ensure that the add-on code is not improperly paid.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 21, 2023
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