Radiology Coding Alert

Question: Our radiologist performed a service for a hospitalized patient on the hospice service. Medicare denied payment for this service because our service was unrelated to the reason the patient was inhospice. Is there a way to accurately code this scenario to ensure proper payment?

Answer: You should report the services your radiologist performed using modifier GW (Service not related to the hospice patient's terminal condition). You should use modifier GW when your radiologist performs services not related to the hospice diagnosis.

Avoid confusion: Don't let modifier GV (Attending physician not employed or paid under agreement by the patient's hospice provider) throw you off. You'll append modifier GV if your radiologist performs services for a hospice patient, and the radiologist is designated as the attending physician -- which is an unlikely scenario for a radiologist.