Question Hospice Billing and Medicare Part B

floving01

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Hello,
Work for an Oncology office and we have a patient that is in hospice. The Pt wants to still come to the office to get labs drawn but has lab coverage that can be paid under Hospice. Wondering how do we bill this? Do we charge an office visit with a modifier for the hospice lab charge? New at this and I was asked to look into this.
 

thomas7331

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You can't bill for something different that the service that you actually provided - that would be fraudulent.

If you're going to provide a service that is the responsibility of the hospice to cover, then you can make an arrangement with the hospice to do the labs on their behalf and then submit an invoice to them to reimburse you directly. If they're not willing to do that, then the hospice will need to make their own arrangements to provide the lab services for the patient.
 

SharonCollachi

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The patient should be aware that the hospice is now handling their care, unless it is something unrelated to the reason for their hospice status. The patient should not be coming in for office visits or for any reason, unless it is unrelated (which is unlikely).
 
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Check with the hospice. If the labs being done are for a different diagnosis code than what the hospice is billing for a modifier would be appended and the claim billed to the primary insurance. If the lab is related to what the hospice is following for the hospice would have to approve the lab charges prior to the service. If the hospice is not willing to approve and the patient still wants the lab done by your office the patient would need to be billed. Hope this helps.
 
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