Wiki 92004 denial with modifier GW

[jv0081]

Hi,
Please help with this problem. I just started with an Opthalmologist and we saw a hospice patient that has Medicare. We billed 92004 and got a rejected reason from our billing company as service related to hospice care, so I added modifer gw and it came back invalid modifier with code 92004. I spoke to our billing company and they showed me a list of modifiers that go with code 92004 and GW was not one of them. I don't think GV was either. Is there another modifier I can use to bypass the CCI edit and get our claim paid? Thanks.

 

[Valeriethomas]

GV vs GW

There are several factors you need to know before choosing how to bill Medicare for a patient that is admitted to hospice. Who is the admitting MD? What is the admitting diagnosis? There are several help tools on the web to help in determining how to bill in this situation. I have one printed at my office that we like to use. If you would like a copy, email me tomorrow @ vthomas@hsvlung.com