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Last Modified: 7/28/2010
Location: FL
Business: Part B
Top claim denials received for Hospice-related services -- Florida
November 1, 2008-April 30, 2009
Following are the top denials, based on frequency count, for claims submitted during the above time frame in Florida with a GV or GW modifier.
• Modifier GV: Attending physician not employed or paid under agreement by the patient’s hospice provider
• Modifier GW: Services not related to the hospice patient’s terminal condition
Select the denial code below to view tips and resources available to help you avoid the denial and correct your denied claim.
• Tips on how to avoid other claim denials you may have received are available in our top Part B claim denials tip sheet.
Frequency count: 5,301
Duplicate claim/service
Frequency count: 786
Services are not covered because the patient is enrolled in a hospice
Frequency count: 174
Provider not certified/eligible to be paid for this procedure/service on this date service
Frequency count: 115
Benefit for service is included in payment/allowance for another service/procedure already adjudicated
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