Diagnosis and attending physician are key when billing Medicare for patient enrolled in Hospice. If your Medicare B carrier is Noridian, then the following information is from Medicare B News Issue 232 October 31, 2006:
If the beneficiary is seen by any physician other than his/her primary attending physcian for a "hospice diagnosis," submit the charge to Hospice.
If the beneficiary is seen by a physcian other than his/her primary attending physician for any diagnosis other than the hospice diagnosis, submit the claim to Medicare Part B.
If the beneficiary is seen by his/her primary attending physician for any diagnosis, including the hospice diagnosis, the claim should be sumitted to Medicare Part B.
You need to contact your hospice for confirmation of the "hospice diagnosis" and the patient's attending physician.
You need modifier GW when services are not related to hospice patient's terminal condition and GV when billing for the attending physician for the terminal condition, unless employed or paid by Hospice (see HCPCS book under modifiers).
Kay Ruhe, CPC, CCS-P
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