E/M Coding Alert - 2021 Issue 5
Reader Questions: Review the Particulars on Billing Medicare for Hospice Care
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Article Overview
This article discusses a common Medicare hospice billing scenario and explains how providers should think about claim responsibility when a patient is enrolled in hospice. It is aimed at medical billers, coders, and physician practices that need general guidance on hospice-related Medicare claims, payer coordination, and related administrative checks before submitting services.
Why This Topic Matters
Hospice enrollment can affect which entity is responsible for payment and how claims are processed. Understanding the general billing context helps practices avoid avoidable denials and verify hospice status before services are rendered.
What You Will Learn
- How hospice enrollment can affect Medicare claim handling
- What to consider when a service is denied for a hospice patient
- Why verifying hospice enrollment status matters before providing services
- General claim-submission issues that may arise in hospice-related billing
Who Should Read This
- Medical coders
- Medical billers
- Physician practices
- Revenue cycle staff
- Medicare billing staff
Modifiers Discussed
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