Gw Modifier For Care Unrelated to Hospice terminal Care

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Many billers think that if a sick person is a Hospice sick person that they cannot get reimbursed for services if they are not reimbursed by the Hospice carrier. But no ifs ands or buts there is a modifier, Gw, that indicates that the care is unrelated to the patient's terminal condition. In order for a sick person to receive Hospice services they must have a life expectancy of six months or less if the terminal illness or disease runs its general course.

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How is Gw Modifier For Care Unrelated to Hospice terminal Care

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Many habitancy mistakenly think that this means that the sick person must be bed ridden or critically ill. However, that is not all the time the case. In fact, many hospices encourage the patients to continue with social and recreational activities as long as they are able. They try to make the patient's last few months, or weeks as fulfilling as possible.

This in some cases means that the sick person may need to see a healing supplier for something that is not connected to the terminal condition. For example, maybe the sick person has low back pain and looking a chiropractor gives the sick person relief. Their terminal condition is an inoperable brain tumor, or an inoperable aortic aneurysm. The back pain is not connected to the terminal condition. The sick person receives relief from the chiropractic manipulation.

The chiropractor can still see the sick person even though they are receiving hospice and the chiropractor doesn't have to get hospice to agree to pay for the care. They can bill the patient's assurance using the Gw modifier to indicate "service not connected to the hospice patient's terminal condition".

There are other examples of care that can be rendered that is not connected to the terminal condition. Maybe the sick person gets conjunctivitis and needs to see an ophthalmologist to get treatment. Again, the service is unrelated to the terminal condition, but you can't just ignore the conjunctivitis.

For me the problem is that I use the Gw modifier so infrequently that when I need it I can't remember which modifier it is. So I decided to make it an entry in my rolodex so that when it comes up, I can find it easily! Hey, whatever works.

Solutions healing Billing Inc

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