Wiki Patient enrolled in a Hospice - Medicare Denial

[Cpeterson2010]

I need advice to a denial from Medicare today.
I have a patient that is in a facility (designated as a Assisted Living Facility) but a hospice bed.
I have billed this with a POS 13 (ALiving) with CPT code 99335. It has been denied due to "Patient enrolled in a Hospice". Any advice; I just can't seem to get this paid!

Thank you in advance

Charisse

 

[mitchellde]

you probably need one of the hospice modifiers, one is gw and I forget the other one.

 

[RebeccaWoodward*]

You would report the GW modifier (service not related to the hospice patient's terminal condition) if the service was unrelated to the hospice condition.

The other is GV-

http://www.cms.gov/manuals/downloads/clm104c11.pdf

Section 50

 

[Cpeterson2010]

Modifier on Hospice Claim

That is it! I am closing in on these claims; I had forgotten my GV or GW modifiers.

Thanks so much!

Charisse