Wiki Billing when pt has active coverage in hospice

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mishortho@sbcglobal.net

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Hello, we have a patient that came in for office visit, xrays, and injection. She has traditional medicare and the claim came back as denied since pt has active coverage in hospice. When our billing department called on the claim they suggested we either add modifier QW or QV. Can someone explan this to me? And also, does the modifier go on everything or just the E/M code?
 
Here are two good MAC resources for -GV vs -GW since I don't know where you're located/which MAC applies.
Basically, the PROFESSIONAL services provided are billed to Medicare with the appropriate modifier. The TECHNICAL components are billed to the hospice. If you did not contact the hospice prior, you may have difficulty getting any payment from the hospice.
 
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