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Hospice Care- but seen by MD in office

T

toots9798@hotmail.com

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West Branch, IA
I have a patient who lives at home, but is enrolled in hospice care. She was seen a couple times by my provider in the office and claims are being denied stating that she is "under hospice care" Does hospice bring their own MD's in to see patients, or why can she not see her PCP since she is still at home? Or do I need to append a modifier? This is new to me, as we do not have many hospice patients. This patient had E/M and labs both visits that are being denied. Thank you!
 
toots9798@hotmail.com said:
I have a patient who lives at home, but is enrolled in hospice care. She was seen a couple times by my provider in the office and claims are being denied stating that she is "under hospice care" Does hospice bring their own MD's in to see patients, or why can she not see her PCP since she is still at home? Or do I need to append a modifier? This is new to me, as we do not have many hospice patients. This patient had E/M and labs both visits that are being denied. Thank you!
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Hospice is financially responsible for the patient for all services related to the hospice diagnosis. You would need to bill the hospice for reimbursement. Are you contracted with the hospice?
 
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In our practice, the gyn oncologists have always been the attending physician (and are not paid by/contracted with any hospice agency). Any office visits are billed with -GV to Medicare part B. Check the reference provided by @Partha45 but I believe any labs/diagnostic testing will not be paid.
 
Of course, Lab/Diagnostic will not be paid. OB-GYN has a specific set of guidelines. If I have anything I will post it here. Meantime, I recommend you verify the OBGYN-related guidelines.
 
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