hospice

  1. M

    Wiki billing RPM and CCM services for hospice patients

    Hello I have a few questions in regards to billing RPM and CCM services with patients who are enrolled in hospice; 1) Should patients in hospice be billed for this service at all? 2) If a patient has passed away in the middle of the month, can any of these codes still be billed (99453, 99454...
    • MagenD
    • Thread
    • billing chronic care management coding hospice remote patient monitoring
    • Replies: 1
    • Forum: Billing/Reimbursement
  2. B

    Wiki Hospice Modifiers

    Hello! I am coding for a Hospice group and all of our claims for a patient have been denied from Amerigroup Medicaid for modifier TG. I have looked at the website they provided and I cannot find a modifier for High/complex level of care that is Medicaid approved. Anyone have any ideas for what...
  3. H

    Wiki Palliative Care coding

    Hi, I’m aware that there are no specific E/M codes that are dedicated to Palliative Care at this point. However, I was wondering if anyone would be willing to share what codes they typically use. I have pulled the clinician home visits and advanced planning codes but would anyone be willing to...
  4. M

    Wiki Billing for Hospice service after discharge from facility

    I am trying to find out how to appropriate bill for the admission to Hospice service that my physician discharged from hospital to hospice on Friday (last week). We use to be able to charge the G0180 hospice certification, but now this code seems only to be for Home Health and not Hospice. Can...
  5. L

    Wiki Hospice Location Modifier

    I work for an ambulance provider and lately, we've been seeing people who have elected hospice and are being transported to a relative's home to receive hospice care. Would the destination (relative's home) be considered an R (residence) modifier or an S (scene) modifier? I can't find anything...
  6. L

    Wiki Medicare Hospice Location Question

    I work for an ambulance provider and lately, we've been seeing people who have elected hospice and are being transported to a relative's home to receive hospice care. Would the destination (relative's home) be considered an R (residence) modifier or an S (scene) modifier? I can't find anything...
  7. S

    Wiki Injury Code As Primary Hospice Diagnosis

    Admitting a new patient to Hospice under the primary diagnosis of Traumatic Brain Injury. Looking for input on the seventh character. As he was already seen at the hospital for this (and is not receiving further treatment due to Hospice admission) I'm hesitant to use "A" as the seventh...
  8. P

    Wiki Hospice Modifiers and Initial vs Subsequent fx

    My team admitted a patient, cared for several days, the patient was transferred to hospice where one of our PA or NP follows the patient as well. When patient was originally under our service she had two fractures, obviously initial encounter. Her hospice diagnosis is for NASH. If we're...
    • patti66
    • Thread
    • fracture charge hospice
    • Replies: 0
    • Forum: Modifiers
  9. B

    Wiki Hospice Inpatient - Provider Not employeed with Hospice

    My provider is a family practice doctor who recently had a Hospice patient as Inpatient. The patient was seen for Hospice related diagnosis and has Medicare as primary and Medicaid secondary.... Can I bill medicaid? I am aware of modifiers GV and GW... We are based in Louisiana. I am having...
  10. M

    Wiki HELP!!!! Hopice/Home health billing!

    I work for a Home Health agency and have billed claims for a patient beginning on 5/3 the patient was discharged from Hospice on 5/2 the patient's insurance (Humana) has denied the claims stating "due to the fact that the patient was under hospice care." I have appealed the decision showing that...
  11. S

    Wiki Medical necessity in the hospice realm

    As a nurse auditor, I'm often presented with cases & claims for dates of service where it's pretty obvious that a recipient doesn't qualify for hospice services based on medical necessity. What we're having difficulty with is rephrasing that terminology so it can be adequately defended if we go...
  12. D

    Wiki Coding for Hospice patient when provider is not the Hospice provider

    We had a patient come in to our office that is a Hospice patient in another location. He was seen for several problems unrelated to his hospice diagnosis. The provider also mentioned his terminal diagnosis in the progress note. Can I bill this with a condition code 07? For treatment of...
  13. C

    Wiki New H/P When Inpatient becomes Inpatient Hospice

    Does anyone know if a physician can bill a new admisson if they dictate a new H/P when a inpatient becomes Hospice inpatient??
  14. J

    Wiki Patient not present

    We have a doctor that went over just the results of lab work with a patient's family member. This patient has dementia and it is difficult to get the patient to the office, patient is not in a SNF and not on hospice. I was wondering how we would code it. Please help.
  15. J

    Wiki Nail Debridement for Hospice Patient

    We bill for a podiatrist who sees patients in various nursing facilities. Among those patients are some in hospice. For a diabetic Medicare patient we are coding a 11720 or 11721 with the Q-modifier, GW modifier, PCP and date last seen by PCP. Medicare is flatly denying all of our nail...
    • jerrypratt
    • Thread
    • 11720 11721 debridement hospice podiatrist
    • Replies: 5
    • Forum: Podiatry
Top