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CAPC Palliative Care Discussion Forum
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Author: MelissaBriggs
Date: Dec 30, 2008 3:38 pm
I am the coder for both our Hospitalist program as well as our Palliative care program. All of these doctors are listed as Internal Medicine doctors per Medicare. When submitting consults for these doctors, Medicare is denying because they are the same specialty, even though the dx's are different. I use the medical reason for the hospitalist and V66.7 as primary for all of palliative care. Am I supposed to be doing something additional for the Palliative care doctors so their services are paid.
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+ Re:Help (by JulieP on 01/05/2009)
WPS the Medicare Carrier in WI is allowing the use of the 77 modifier for these type of circumstances. We often advise our coders to add the 77 to both provider's services to avoid having the carrier deny the service without the modifier.You would never append the 77 modifier if the diagnoses weren't different. I also want to mention that V66.7 is never to be used as a primary diagnosis, you should be looking to code signs or symptoms as the primary diangosis. Don't forget about one of our newer diagnosis codes 338.3 - cancer related pain.

Julie Pipke, CPC
Reimbursement Manager, Medicine
Medical College of Wisconsin
Re:Help (by JulieP on 03/04/2009)
The fax did not go through, our machine attempted four times. You should be able to acess the communique yourself on the WPS Medicare part b website.

Visit this URL to obtain it:
http://www.wpsic.com/medicare/part_b/publications/0303comm.pdf

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