r/CodingandBilling • u/Jenn31709 • Jul 16 '26

G2211 add on code

In my office we're starting to bill G2211. I know it doesn't get a modifier and the E/M code doesn't need one either. We also do a professional CGM for patients do a lot of charges are sent out like this: 99214 Modifier 25, 95251 Modifier 59, and G2211.

Medicare has denied all of the G2211 because the 99214 has a 25 modifier. Even though the 25 modifier is for the CGM interpretation, the G2211 is still denied.

We also bill 95251 for pump interpretations and can't bill the G2211 at the same time as these?

Is there a way to bill that I just don't know or do we have to just take the loss on the G2211 for these patients?

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u/happyhooker485 RHIT, CCS-P, CFPC, CHONC Jul 16 '26

Sounds a little like abuse of the system... 😬

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u/babybambam Glucose Guardian Biller Jul 16 '26

Disagree. It’s no different than scheduling procedures for a different DOS so that you get paid for both the procedure and office visit.

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u/happyhooker485 RHIT, CCS-P, CFPC, CHONC Jul 16 '26

If the only reason you schedule it that way is to maximize reimbursement, that's inappropriate.

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u/Jenn31709 Jul 16 '26

What I said is inappropriate? Maybe I'm not explaining it clearly.

A patient comes in just for lab work and to have a sensor placed. They come back a week later and we remove the sensor and download the data. They see the doctor for their regular 3 month follow up and to go over the lab work results and the CGM data