Question-

Messages
2
Best answers
0
Just a quick question..

I have a patient that received a Prolia injection in the office. The patient has a Medicare advantage plan. The claim was denied due to the patient being enrolled under Hospice. Our local Medicare advantage plan stated that we need to bill Medicare. Would a modifier need to be on the CPT codes signifying that the patient is in Hospice care?

Any feedback would be very helpful!!!

Thank you,

Nicole
 

TammyHF

Guru
Messages
170
Location
Wichita, KS
Best answers
0
The claim needs to be submitted with appropriate Hospice modifier:

GV - Attending physician not employed or paid under agreement by the patient's hospice provider.
GW - Service not related to the hospice patient's terminal condition
 
Top