Question: Which procedure codes should we report for our oncologist's oversight of hospice patients? Are there different codes and guidelines for Medicare and privately insured patients? When billing Medicare carriers, remember that the physician must spend a minimum of 30 minutes treating the patient. For hospice oversight of a Medicare patient, you should use HCPCS code G0182 (Physician supervision of a patient under a Medicare-approved hospice [patient not present] ... within a calendar month, 30 minutes or more).
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Answer: For payers other than Medicare, select from two CPT codes, depending on the time your oncologist spent with the patient:
Furthermore, if you submit G0182 to Medicare for an attending physician who provides treatment and management services of a hospice patient's terminal illness, such as advanced colon cancer (153.x), but wasn't affiliated with the hospice center, append modifier -GV (Attending physician not employed or paid under arrangement by the patient's hospice provider).
When the oncologist treats a hospice patient for services unrelated to the patient's terminal condition, and the physician doesn't work for the hospice center, use modifier -GW (Service not related to the hospice patient's terminal condition).