HI All.

We have been doing a lot of research on billing for hospice services and have a few (just a few?!?) unanswered questions. If anyone has some insights to the following I would really appreciate it.

1. When a hospice patient dies at home in the presence of the hospice physician who did not do an exam because the patient expired just after he arrived, is it appropriate to code an e/m based on what the provider documented for the visit? If the patient is inpatient or snf, we would code a discharge, but there are no corresponding codes for home or alf patients.

2. Is anyone aware of any guidance, either from CMS or any of the MAC's, as to how e/m CPT's (which are usually submitted to Part B) are viewed by Part A? For instance, do the CPT definitions for new vs. established patients apply? Or do the AMA requirements for documenting for time-based coding apply?

Many thanks to anyone courageous enough to dive into these waters.

Karen