Practice Management Alert

Question: We have a patient our physician performed an incision and drainage procedure on. The EOB came back saying they would not pay because he is in hospice. I contacted the hospice people and they said that they should pay because this procedure had nothing to do with why he is in hospice. He is in hospice because of COPD. She said there should be a code to use (maybe a modifier) or something to let the insurance company know that this is not a hospice problem? What we should be using to bill this correctly?Pennsylvania SubscriberAnswer: You should report the services your physician performed using modifier GW (Service not related to the hospice patient's terminal condition). You'll use modifier GW when your physician is performing services not related to the hospice diagnosis -- in this case, anything unrelated to the patient's chronic obstructive pulmonary disease (COPD).Typically, just as in your [...]