G2211 and E/M With Modifier 25
This update applies to our Medicare members.

Effective October 1, 2024, consistent with the Centers for Medicare & Medicaid Services (CMS) published coding guidance, code G2211 will deny when billed on the same date of service as an office and outpatient E/M visit when reported with modifier 25, for the same patient by the same physician or non-physician practitioner.

Aetna's July 2024 OfficeLink Update is Available HERE.
A Few Articles You Will Want to Check Out:

• Non-physician provider types for E&M denials
• Changes to our National Precertification List (NPL)
• Unit limits reminder