UCR 228: G0559 clarification, GC Modifier Explained, and G2211 documentation suggestion.

January 24, 2025 

Scott, Mark, and Dr. Ray Painter address questions submitted to the PRS Network.

1. I recently attended your Billing and Coding conference in Las Vegas this past December. 
   I need clarification on New CPT code G0559, can someone please contact me as soon as possible.
2. From a coding perspective, I have a question regarding the GC modifier for a teaching facility. Also, is there a difference between the coding perspective and the compliance side of the question?
   How crucial is adding the modifier GC to the encounter when a patient is seen by both the Resident and the Faculty member?
3. Appreciate any insight y'all can provide.
4. My coder is requiring me to add a statement for G2211 codes.
5. "E and M visit today is associated with current or anticipated ongoing medical care services related to a patient's single serious condition or complex condition."
   
   Is this necessary? Reading the CMS guidelines they say no. They are worried about "Bulletproof" Documentation. I am coding these with many of my follow up patient who have chronic BPH, OAB, ED and cancer. Thoughts on how to respond to them? 

Free Kidney Stone Coding Calculator

Download Now

PRS Billing and Other Services - Book a Call with Mark Painter or 
Marianne Desciose

Click Here to Get More Information and Request a Quote

Urology Advanced Coding and Reimbursement Seminar - New Orleans, LA

Register Now for the Urology Advanced Coding and Reimbursement Seminar

Click Here for Information and Registration

Event Details

Location:
New Orleans: January 31-February 1, 2025, at Harrah's

Time: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pm

Includes: Breakfast and Lunch on both days, plus 14 AAPC CEUs

Click Here to Start Your Free Trial of AUACodingToday.com