Wiki Hospice care billing

[ppma]

I had a hospital patient who transferred to the hospice care unit in the same hospital. I billed 99203, but Medicare denied. What is the appropriate code I should bill??

 

[p.stewart@lomarassociates.com]

hospice

Are you billing for a physician who is seeing the patient in the hospice facility? If yes is the physician seeing the patient employed by the hospice facility?

 

[heartyoga]

Modifier -GV

We use modifier GV. Our doc is not employed by hospice nor the hospital.

Reference: https://www.cms.gov/outreach-and-ed...k-mln/mlnmattersarticles/downloads/se1321.pdf

 

[ppma]

Yes, he is a hospitalist. I was thinking to rebill with GV also. Thanks for both of you!

 

[heart123]

A GW Mod is what I bill and get paid no problem

 

[himanib]

Services can be billed by physician or other qualified professional such as NP if they are selected to be hospice patient's attending physician. Use modifier -GV if the pt is being seen for hospice terminal diagnosis, and -GW if the pt is being seen for a condition unrelated to hospice terminal diagnosis. In both cases the provider should not be related to/employed by hospice.