05/09/2023

GW Modifier Requirements

What is required for using the GW code for hospice patients? Does it have to be in documentation? Please explain requirements?

The GW modifier is billed by a professional provider when the patient’s chief complaint is not related to the terminal condition that caused the patient to elect hospice. For example, a patient who may require diabetic routine foot care when their terminal condition is related to cancer or heart failure. There are no specific documentation requirements in the patient’s chart for using this modifier. It should be appended to any professional service where the treatment is not related to their terminal illness. This modifier is only used for clerical reasons, since charges would automatically deny without it being appended to the claim.