Excluding Service from the Hospice Election

This webinar occurred on 3/26/26.

Medicare uses modifiers or a condition code to exclude services from the hospice election. The data is for 2025’s last quarter, and this is one of our top denials. During this education, we will:
• Define the modifiers GV and GW
• Explain condition codes affecting the hospice election
• Explain the data and why this is important

Resources
WPS SNAP (Secure Net Access Portal) User Manual
https://www.wpsgha.com/tools/portal-user-manual

Direct Date Entry (DDE)
https://www.wpsgha.com/guides-resources/view/511

HIPAA Eligibility Transaction System (HETS)
https://www.cms.gov/data-research/cms-information-technology/hipaa-eligibility-transaction-system

Medicare Benefit Policy Manual, Chapter 9, Sections 20.1 and 40.1.3.1
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c09.pdf

Medicare Benefit Policy Manual, Chapter 9, Section 20.2.1
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c09.pdf

Medicare Managed Care Manual, Chapter 4 - Benefits and Beneficiary Protections, Section 10.4
https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/mc86c04.pdf

Chapters
00:00 Intro
02:52 Coverage Basics
17:50 Claims Data
24:42 Excluding the Services
39:47 Questions and Answers
54:20 Closing Comments

Видео Excluding Service from the Hospice Election канала WPS Government Services – Medicare