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Wiki CPT 67028 and hospice care

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MichelleAKing

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Does anyone know if Medicare will pay for a patient who is in hospice care to have eye injections for macular degeneration? CPT 67028
 
They probably will. The question though is, since the patient is in hospice and most likely not expected to live much longer, is the injection beneficial for the patient at this time? Just wondering.

Tom Cheezum, OD, CPC, COPC
 
I also think it would be covered, but you will need to use -GW modifier.
I too would question the medical necessity of the service, but I suppose it is possible if the patient is at the beginning of hospice and expected to live another several months. From my experience, patients typically enroll in hospice with only very short times left.
 
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