Wiki Hospice Modifier GV and GW

jaud63

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Local Chapter Officer
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Gv- Attending MD professional services
GW- Services not related to Hospice pts terminal illness

We have taken over services of a clinic and we have received Medicare denials (code B9) which indicate the patient is a hospice patient. We are trying to determine if we can bill for services using one/both of these modifiers.

Can we use GV if the patient is a clinic pt? Our encoder does not indicate that this modifier applies to clinic services. If not, how do we get our clinic services paid without a modifier?

Do we really need to be concerned about the patients hospice diagnosis for the services that we have billed for the hospital? How would we possibly know that diagnosis or receive it with privacy guidelines if our physicians rounded on someone elses patient in the hospital and our physician was not responsible for that particular diagnosis?

Thanks
 
The GV modifier is used if the attending physician is not employed or paid under the agreement by the patient's hospice provider.

The GW is used for services that are not related to the hospice patient's terminal illness.

Hope this clears it up!
 
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