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hospice billing

  1. Question hospice billing
    Medical Coding Books

    I am trying to bill a claim for a patient who has signed up with hospice. We saw her in the hospital. Medicare has denied the claim with the reason of: PR-B9 : Services not covered because the patient is enrolled in a Hospice.

    Do I have to bill hospice patients different then regular patients? Thanks for any help!

  2. #2
    North Carolina
    Was the condition related to her hospice condition? If not, you need to bill with a modifier.

    GW modifier “service not related to the hospice patient's terminal condition.”

    Section 50

  3. #3
    Rebecca is correct but if the Dx IS related to the hospice stay than you have to bill the hospice that the patient is assigned to.

  4. Smile
    Thank you both for your help!

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