GW - JE Part B

Condition not related to the patient's terminal condition

Instructions

• Submit when a service is rendered to a patient enrolled in a hospice, and service is unrelated to patient's terminal condition
• All providers must submit this when this condition applies

Claim Coding Example

Patient is on hospice for congestive heart failure and goes to the office for a toe nail trim. The procedure is unrelated. The GW modifier should be added to the CPT for the toe nail trim.

Resource

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 11, Section 40