Avoid Hospice Coding Headaches With Modifiers GV and GW

Posted on 12. Feb, 2010 by Editor.

Differentiating between GV and GW is your first step.

If your urologist sees and treats hospice patients, you probably feel like you have to jump through hoops to get paid. The key to bringing in every hospice-related dollar your urologist deserves is ensuring you append the right modifier.

Base Modifier GV or GW Choice on Diagnosis

When reporting services your urologist provides to a hospice enrolled patient, “the most important thing you need to pay attention to is the correct modifier to use,” says Jane Marks, financial services manager at Anne Arundel Urology in Annapolis, Md. “You also need to pay attention to the diagnosis that is on your claim and whether that diagnosis is related to the terminal illness or not.”

The diagnoses the hospice submits for its patients affect how you bill and what reimbursement (if any) your urologist will receive. If you know which diagnosis the hospice uses, you’ll know whether to append modifier GV (Attending physician not employed or paid under agreement by the patient’s hospice provider) or modifier GW (Service not related to the hospice patient’s terminal condition).

Here’s how:

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A Physician Coder’s Guide to the 2010 OIG Work Plan

Posted on 13. Oct, 2009 by .

If your practice does lab panels, sleep studies, hospice visits and more, take heed.

The HHS Office of Inspector General has published its 2010 Work Plan, which should give us all a heads up on what the watchdog agency will be auditing and evaluating this year.

Why you should care: The 115-page document is like a map for what regulators will be looking at this year, and what potential problems they’ll be passing to MAC, RAC and private payer auditors. Don’t worry. Physician issues are clustered around page 15. However, if you code for other things in your health system besides physician services, you should have a look at the table of contents.

Here’s a summary of what the OIG wants to know about physician reimbursement:

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