Medical Billing Forum

Coding => Coding => Topic started by: rbolinger on July 25, 2008, 10:38:16 AM

Title: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: rbolinger on July 25, 2008, 10:38:16 AM
I have a physician having trouble getting paid for hospice patients. He is a Rural Health Clinic. Also can he get paid for care plan oversight??
They use form UB 92 for their billing. I am trying to find what codes or modifier codes they need to use.

Please help  :)


Robert
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: Michele on July 25, 2008, 11:34:00 AM
Hi Robert,
   So are you billing for Hospice services?  If so, you should be using the UB04.  It replaced the UB92 last year.  Very similar, just a few small changes.  Mostly to accommodate the NPI number. 

   As for the codes, you are going to be using rev codes instead of cpt codes. 

   If you need instructions on completing a UB04 form we offer a book that covers each box on the form in detail, and gives you a list of rev codes.  You can find more info on the book at

http://www.medicalbillinglive.com/UB04-forms-book.shtml

Hope that helps!

Michele
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: rbolinger on August 12, 2008, 03:30:46 PM

One more question is This physician is a rural clinic provider and tell me they can not bill for care plan oversight. Is they any other info you may give me to let this physician know what all he can bill for on a patient receiving hospice care??


Thanks

Robert
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: Michele on August 12, 2008, 09:34:54 PM
It sounds like you are billing for the physicians charges which would go on a CMS1500 form.  Plan oversight can be billed using CPT codes 99339 or 99340. 

Codes 99339 and 99340 report development of complex and multidisciplinary care modalities and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s)(e.g. legal guardian) and /or key caregiver(s) involved in the patientís care, integration of new information into the medical treatment plan and/or adjustment of medical therapy.

Hope that helps.

Michele
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: jns85008 on August 22, 2008, 04:22:25 AM
Use a GW modifier for hospice patients. You will get paid!
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: Michele on August 22, 2008, 10:56:02 AM
The GW Modifier is used to indicate - Service not related to the hospice patientís terminal condition.  If the services you are billing are not related to the Hospice condition then the GW modifier will work.

Thanks for the info!

Michele
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: Jane on December 29, 2010, 11:44:01 AM
I bill for a doctor who is not employed by the hospice organization but is listed as the attending physician for the hospice patient seen in a nursing home setting.  On occasion his employee, a nurse practitioner, will see a hospice patient.  Although I have received payment for her visits, more often they are denied.  Medicare said that only the physician can bill for hospice related diagnosis and the Q5 modifier is for physicians only and not a NP.  Any suggestions for a solution?
Title: Re: WHAT CODE TO USE ON FORM UB 92 FOR HOSPICE PATIENTS
Post by: Michele on December 30, 2010, 08:00:10 AM
Medicare does allow NP's to bill for services to Medicare beneficiaries who have enrolled in hospice program if the NP is the 'attending physician'.  It sounds like the problem is because the NP is not the 'attending physician' but that her employer the MD is.  I would recommend contacting Medicare to see if there is anyway that you can indicate that the NP is an employee of the attending physician or if the billing can be done under the MD since he is the employer of the NP.

Michele