G2211 and New 2024 Billing Opportunities

Description

Implementing New Medicare Billing Opportunities in Your Office

Medicare physician final rule introduced multiple new billing opportunities for physician practices, such as value-added care for patients needing long-term treatment of complex patients (G2211). This add-on code provides additional payments to providers' long-term monitoring and developing an ongoing relationship with their complex patients. G2211 has not been without confusion on when and how to report. Another opportunity is to evaluate patients who may have social issues impacting their healthcare (G0136) and help these patients overcome these issues through trained personnel, G0019, and G0022 Community Health Integration (CHI) services.

Caregiver training (96202, 96203, 97550, 97551, and 97552) using a wide range of auxiliary personnel. Lastly, Principle Illness navigation (PIN) (G0023, G0024, G0140, and G0146) is a new billing opportunity for helping patients diagnosed with high-risk conditions — e.g., cancer, mental health conditions, substance use disorder (SUD), etc. identify and connect with appropriate practitioners and providers in a timely manner for care and support resources.

Speaker

Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a health care consultant Jan has more than 45 years of experience in physician billing, reimbursement, and compliance. Jan is currently the owner of Professional Coding Solutions, a healthcare consulting firm. She has been a Certified Professional Coder (CPC) since 1992. As a member of the American Academy of Professional Coders (AAPC) Jan previously served on their Advisory Board as the liaison to the AMA, has been a speaker for the AAPC annual conference as well as contributed to the development of the original AAPC’s independent study, university education programs, and proficiency tests. In 1994, she was honored by AAPC as Networker of the Year. Jan was also a Regional Governor for the American College of Medical Coding Specialists (ACMCS) serving as Chair of the Ethics committee and a member of the Examination committee.

In her role as a physician consultant, she has participated in physician coding and documentation reviews including OIG government PATH and Campus audits, and designed and conducted physician coding seminars nationwide. She has been a guest speaker for several conferences sponsored by United Communications, Inc//Decision Health, AAPC as well as Coding Institute Specialty Conferences.

In previous consulting positions, she was responsible for developing and conducting seminars for basic, intermediate, and advanced ICD-9-CM and CPT, teaching physician guidelines as well as special seminars for OB/GYN, Orthopedics, Urology, Gastroenterology, General Surgery, ENT, Cardiology, Emergency Medicine and Evaluation and Management. In her role as an educator, she has been teaching E/M documentation and auditing to both physician and coding audiences since 1992 when RBRVS was first implemented.

Jan has also worked for several major health insurance payers in Wisconsin, was a coding advisor to the WPS Medicare Carrier Advisory Committee, and served as the coding and reimbursement coordinator for a 37-provider, staff model HMO clinic. As the coding and reimbursement coordinator, Jan was responsible for physician office, hospital, surgical, and nursing facility coding charge ticket development, fee development, reimbursement analysis, claims analysis, and physician education.

Learning Objectives

Understand the concept behind G2211 and the circumstances when G2211 can and cannot be reported.
Documentation to support billing G2211.
Patient circumstances that may support billing SDOH (G0136).
Required follow-up when identifying patient-specific SDOH issues.
Appropriate caregiver training providers.
Frequency of allowed caregiver services.
Requirements for reporting "incident to" for caregiver trainer, CHI, and PIN services.
Reduce denials and compliance risks.

Areas Covered

Longitudinal Care Definition.
Documentation to support G2211, SDOH G0136, G0019, G0022, 96202, 96203, 97550, 97551 and 97552, G0023, G0024, G0140 and G0146.
Differences in reporting PIN services G0023/G0024 and G0140/G0146.
Providers that may provide all of the above services.
Forms to report SDOH.

Who Should Attend

Physicians and QHP Providers.
Office managers.
Coders.
Auditors.
Denial resolution teams.
Insurance payers.

All Days