Denials for HCPCS G2211
Date Reported:
01/08/2025
Date Updated:
03/13/2025
Date Resolved:
03/12/2025
Status:
Closed
Provider Types Impacted:
Part B providers in Jurisdiction JK and Jurisdiction J6
Reason Code(s):
N/A
Claim Coding Impact:
Claims with HCPCS G2211 with DOS 1/1/2024-9/30/2024
Description of Issue
NCCI editing for HCPCS G2211 code was updated on 12/05/2024 to require HCPCS G0463 as the primary code for G2211 add-on code. This has resulted in denials of claims for the add-code G2211 when billed with CPTs 99202-99205 and 99211-99215. Impacted claims are for DOS 1/1/2024-9/30/2024 when processed on or after 12/5/2024.
National Government Services Action
NGS is fully aware of the issue and has reached out to CMS for instructions. The NGS Provider Call Center has no additional information on these claim denials and calls to the call center on this topic will yield no additional information.
Provider Action
No provider action is indicated.
Proposed Resolution/Fix
A mass adjustment of impacted claims was completed on 3/12/2025.