Internal Medicine Coding Alert

Published on Wed Jul 14, 2004 PDF

Question: What are the differences between modifiers -GV and -GW?

Louisiana Subscriber

Answer: You should use modifier -GV (Attending physician not employed or paid under arrangement by the patient's hospice provider) when the internist provides services related to a hospice patient's terminal illness. But the physician should neither work for nor receive compensation from the hospice service.

When a physician, who may or may not work for the hospice, treats a patient for conditions unrelated to a terminal illness, you can use modifier -GW (Service not related to the hospice patient's terminal condition). For example, your internist treats a hospice patient for pneumonia (480.x), a condition that's unrelated to the patient's terminal cancer.

Therefore, you should use -GW, regardless of whether the physician works for the hospice. But if a physician treated the same patient for the terminal cancer, and the hospice didn't employ or pay the physician, then you should use modifier -GV.