RE: Please help! How to bill for office visit for home hospice patients?

[Guest guest]

Helen,

My understanding is that if you see the patient for dx unrelated

to the reason for hospice, you bill Medicare and there is a modifier that you

have to

Use. If you are seeing them for the hospice dx as the

hospice MD, you bill hospice.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Tuesday, December 07, 2010 12:05 AM

To: practiceimprovement1

Subject: Please help! How to bill for office

visit for home hospice patients?

Please advise us on billing.

Recently with 2 elderly patients discharged from hospital with home hospice

care-with me as the " attending MD " to sign all of the hospice orders.

Patients were brought to my clinic by their children to see me for follow ups.

We billed these visits as regular office visits and did not get any payment

from medicare. Could some of you please let me know how to correctly bill for

the service to supervise the hospice care and their office visits?

Thank you very much in advance.

Helen

CyberDefender has scanned this email for potential threats.

Version 2.0 / Build 4.03.29.01

Get free PC security at http://www.cyberdefender.com

[Guest guest]

A GV modifier on the E & M is necessary.

Good luck!

-

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Monday, December 06, 2010 11:05 PM

To: practiceimprovement1

Subject: Please help! How to bill for office

visit for home hospice patients?

Please advise us on billing.

Recently with 2 elderly patients discharged from hospital with home hospice

care-with me as the " attending MD " to sign all of the hospice orders.

Patients were brought to my clinic by their children to see me for follow ups.

We billed these visits as regular office visits and did not get any payment

from medicare. Could some of you please let me know how to correctly bill for

the service to supervise the hospice care and their office visits?

Thank you very much in advance.

Helen

[Guest guest]

I see them for both hospice related and unrelated issues. Should we bill the usual CPT and EM codes, but with GV modifier in the place where we would enter modifier-25 for procedure?Thank you.HelenTo: From: cjw@...Date: Tue, 7 Dec 2010 07:04:28 -0600Subject: RE: Please help! How to bill for office visit for home hospice patients?

A GV modifier on the E & M is necessary.

Good luck!

-

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Monday, December 06, 2010 11:05 PM

To: practiceimprovement1

Subject: Please help! How to bill for office

visit for home hospice patients?

Please advise us on billing.

Recently with 2 elderly patients discharged from hospital with home hospice

care-with me as the "attending MD" to sign all of the hospice orders.

Patients were brought to my clinic by their children to see me for follow ups.

We billed these visits as regular office visits and did not get any payment

from medicare. Could some of you please let me know how to correctly bill for

the service to supervise the hospice care and their office visits?

Thank you very much in advance.

Helen

[Guest guest]

Exactly. Put the GV modifier on ANY code submitted while

the patient is in hospice. This indicates that you are not an employee of

the hospice agency. (which I assume you are not).

Regards,

Chris

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Tuesday, December 07, 2010 7:40 AM

To: practiceimprovement1

Subject: RE: Please help! How to bill for office

visit for home hospice patients?

I see them for both hospice related and unrelated issues. Should we bill the

usual CPT and EM codes, but with GV modifier in the place where we would enter

modifier-25 for procedure?

Thank you.

Helen

To:

From: cjw@...

Date: Tue, 7 Dec 2010 07:04:28 -0600

Subject: RE: Please help! How to bill for office visit

for home hospice patients?

A GV

modifier on the E & M is necessary.

Good luck!

-

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Monday, December 06, 2010 11:05 PM

To: practiceimprovement1

Subject: Please help! How to bill for office

visit for home hospice patients?

Please advise us on billing.

Recently with 2 elderly patients discharged from hospital with home hospice

care-with me as the " attending MD " to sign all of the hospice orders.

Patients were brought to my clinic by their children to see me for follow ups.

We billed these visits as regular office visits and did not get any payment

from medicare. Could some of you please let me know how to correctly bill for

the service to supervise the hospice care and their office visits?

Thank you very much in advance.

Helen

[Guest guest]

My understanding is that is only for Dx not related to the

hospice Dx. And if seeing them for hospice related DX you bill hospice for the

E & M.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of

Wenner MD

Sent: Tuesday, December 07, 2010 9:12 AM

To:

Subject: RE: Please help! How to bill for office

visit for home hospice patients?

Exactly. Put the GV modifier on

ANY code submitted while the patient is in hospice. This indicates that

you are not an employee of the hospice agency. (which I assume you are not).

Regards,

Chris

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Tuesday, December 07, 2010 7:40 AM

To: practiceimprovement1

Subject: RE: Please help! How to bill for office

visit for home hospice patients?

I see them for both hospice related and unrelated issues. Should we bill the

usual CPT and EM codes, but with GV modifier in the place where we would enter

modifier-25 for procedure?

Thank you.

Helen

To:

From: cjw@...

Date: Tue, 7 Dec 2010 07:04:28 -0600

Subject: RE: Please help! How to bill for office visit

for home hospice patients?

A GV modifier

on the E & M is necessary.

Good luck!

-

From:

[mailto: ] On Behalf Of Helen Yang

Sent: Monday, December 06, 2010 11:05 PM

To: practiceimprovement1

Subject: Please help! How to bill for office

visit for home hospice patients?

Please

advise us on billing.

Recently with 2 elderly patients discharged from hospital with home hospice

care-with me as the " attending MD " to sign all of the hospice orders.

Patients were brought to my clinic by their children to see me for follow ups.

We billed these visits as regular office visits and did not get any payment

from medicare. Could some of you please let me know how to correctly bill for

the service to supervise the hospice care and their office visits?

Thank you very much in advance.

Helen

CyberDefender has scanned this email for potential threats.

Version 2.0 / Build 4.03.29.01

Get free PC security at http://www.cyberdefender.com

[Guest guest]

Professional services of attending physicians, who may be nurse practitioners,

furnished to hospice beneficiaries are coded with modifier GV. (Attending

physician not employed or paid under arrangement by the patient's hospice

provider); the GW modifier is billed for services unrelated to the terminal

illness

CMS Pub 100-4, Chap 11 Section 40.2; or CR 3226

Your local hospice should be able to help you with billing problems. Since

you're the primary, you should get paid for visits regardless of the diagnosis.

Also, if you spend at least 30 minutes a month, you can bill for oversight.

http://www.nhpco.org/i4a/pages/index.cfm?pageid=5583

http://www.nhpco.org/i4a/pages/index.cfm?pageid=5551

Medicare Codes for Care Plan Oversight

http://www.suttervnaandhospice.org/doctors/doctors_cpo.html

Codes for care plan oversight are: GO181 for home health, and GO82 for hospice.

You may bill for 30 minutes of care plan oversight a month, including medical

decision making; review of charts, reports, or treatment plans; review of lab or

study results that weren't ordered during or associated with a face-to-face

encounter; phone calls to other health professionals involved in the care of the

patient; phoning in prescriptions; and other items on the home care or hospice

patient's behalf.

Medicare Codes for Home Health Certification and Recertification

Medicare will also reimburse physicians separately just for signing the 485

(home care treatment plan), even if you do not spend the required minimum of

30-minutes of oversight to bill for CPO. This applies to home care only, not

hospice.

The code for certification of home care treatment plans is GO180. The code for

recertification is GO179.

The physician billing for CPO must document in the patient's record the

services furnished and the date and length of time associated with those

services.

A blessing on you for easing their suffering.

[Guest guest]

,

Thanks so much for the clarifications and modifiers....

(Now where the heck is ????

To: Sent: Tue, December 7, 2010 4:12:41 PMSubject: Re: Please help! How to bill for office visit for home hospice patients?

Professional services of attending physicians, who may be nurse practitioners, furnished to hospice beneficiaries are coded with modifier GV. (Attending physician not employed or paid under arrangement by the patient's hospice provider); the GW modifier is billed for services unrelated to the terminal illnessCMS Pub 100-4, Chap 11 Section 40.2; or CR 3226 Your local hospice should be able to help you with billing problems. Since you're the primary, you should get paid for visits regardless of the diagnosis. Also, if you spend at least 30 minutes a month, you can bill for oversight.http://www.nhpco.org/i4a/pages/index.cfm?pageid=5583http://www.nhpco.org/i4a/pages/index.cfm?pageid=5551Medicare Codes for Care Plan Oversighthttp://www.suttervnaandhospice.org/doctors/doctors_cpo.htmlCodes for care plan oversight are: GO181 for home health, and GO82 for hospice.You may bill for 30 minutes of care plan

oversight a month, including medical decision making; review of charts, reports, or treatment plans; review of lab or study results that weren't ordered during or associated with a face-to-face encounter; phone calls to other health professionals involved in the care of the patient; phoning in prescriptions; and other items on the home care or hospice patient's behalf.Medicare Codes for Home Health Certification and RecertificationMedicare will also reimburse physicians separately just for signing the 485 (home care treatment plan), even if you do not spend the required minimum of 30-minutes of oversight to bill for CPO. This applies to home care only, not hospice.The code for certification of home care treatment plans is GO180. The code for recertification is GO179. The physician billing for CPO must document in the patient's record the services furnished and the date and length of time associated with those

services.A blessing on you for easing their suffering.

[Guest guest]

Thank you all for the helpful information. We will try again to contact the local hospice again too.HelenTo: From: peterl@...Date: Tue, 7 Dec 2010 21:12:41 +0000Subject: Re: Please help! How to bill for office visit for home hospice patients?

Professional services of attending physicians, who may be nurse practitioners, furnished to hospice beneficiaries are coded with modifier GV. (Attending physician not employed or paid under arrangement by the patient's hospice provider); the GW modifier is billed for services unrelated to the terminal illness

CMS Pub 100-4, Chap 11 Section 40.2; or CR 3226

Your local hospice should be able to help you with billing problems. Since you're the primary, you should get paid for visits regardless of the diagnosis. Also, if you spend at least 30 minutes a month, you can bill for oversight.

http://www.nhpco.org/i4a/pages/index.cfm?pageid=5583

http://www.nhpco.org/i4a/pages/index.cfm?pageid=5551

Medicare Codes for Care Plan Oversight

http://www.suttervnaandhospice.org/doctors/doctors_cpo.html

Codes for care plan oversight are: GO181 for home health, and GO82 for hospice.

You may bill for 30 minutes of care plan oversight a month, including medical decision making; review of charts, reports, or treatment plans; review of lab or study results that weren't ordered during or associated with a face-to-face encounter; phone calls to other health professionals involved in the care of the patient; phoning in prescriptions; and other items on the home care or hospice patient's behalf.

Medicare Codes for Home Health Certification and Recertification

Medicare will also reimburse physicians separately just for signing the 485 (home care treatment plan), even if you do not spend the required minimum of 30-minutes of oversight to bill for CPO. This applies to home care only, not hospice.

The code for certification of home care treatment plans is GO180. The code for recertification is GO179.

The physician billing for CPO must document in the patient's record the services furnished and the date and length of time associated with those services.

A blessing on you for easing their suffering.