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Thread: Patient enrolled in a Hospice - Medicare Denial

  1. #1

    Default Patient enrolled in a Hospice - Medicare Denial

    AAPC: Back to School
    I need advice to a denial from Medicare today.
    I have a patient that is in a facility (designated as a Assisted Living Facility) but a hospice bed.
    I have billed this with a POS 13 (ALiving) with CPT code 99335. It has been denied due to "Patient enrolled in a Hospice". Any advice; I just can't seem to get this paid!

    Thank you in advance


  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    you probably need one of the hospice modifiers, one is gw and I forget the other one.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007
    North Carolina


    You would report the GW modifier (service not related to the hospice patient's terminal condition) if the service was unrelated to the hospice condition.

    The other is GV-


    Section 50
    Last edited by RebeccaWoodward*; 08-02-2010 at 09:32 AM. Reason: link provided

  4. #4

    Default Modifier on Hospice Claim

    That is it! I am closing in on these claims; I had forgotten my GV or GW modifiers.

    Thanks so much!


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