COVERAGE CRITERIA
In addition to the information referenced above, the following coverage criteria must be met before claim can be considered for processing.
Vehicle and Crew Requirements
Ambulance Vehicle: Any vehicle used as an ambulance must be designed and equipped to respond to medical emergencies and, in non-emergency situations, be capable of transporting beneficiaries with acute medical conditions. The vehicle must comply with State or local laws governing the licensing and certification of an emergency medical transportation vehicle. At a minimum, the ambulance must contain a stretcher, linens, emergency medical supplies, oxygen equipment, and other lifesaving emergency medical equipment and be equipped with emergency warning lights, sirens, and telecommunications equipment as required by State or local law. This should include, at a minimum, one 2-way voice radio or wireless telephone.
The ambulance must have customary patient care equipment and first aid supplies, including reusable devices and equipment such as backboards, neck boards, and inflatable leg and arm splints. These are all considered part of the general ambulance service and payment for them is included in the payment rate for the transport.
Basic Life Support (BLS) Ambulance – BLS vehicles must be staffed by at least two people, at least one of whom must be certified as an emergency medical technician (EMT) by the State or local authority where the services are being furnished and be legally authorized to operate all lifesaving and life-sustaining equipment on board the vehicle.
Advanced Life Support (ALS) Ambulance – ALS vehicles must be staffed by at least two people, at least one of whom must be certified by the State or local authority as an EMT-Intermediate or an EMT-Paramedic.
Medicare Ambulance billing. Ambulance billing codes, Air ambulance billing guide and reimbursement. How and what code to use for correct payment.
Friday, October 8, 2010
Subscribe to:
Post Comments (Atom)
Popular Posts
-
I have received a denial for my submission of specialty care transport HCPCS code A0434. What could be wrong? Answer: Did you submit a p...
-
HCPCS A0429 – Ambulance service, BLS, emergency transport, all inclusive Basic Life Support (BLS) Emergency – When medically necessary, th...
-
Procedure code and description A0425 Ground mileage, per statute mile A0426 Ambulance service, advanced life support, nonemergency trans...
-
HCPCS A0433 – Advanced Life Support, Level 2 Advanced Life Support, Level 2 (ALS 2) – ALS2 is the transportation by ground ambulance vehic...
-
Procedure code and Description A0425 Ground mileage, per statute mile No PAR A0426 Ambulance service, advanced life support, nonemergency...
-
HCPCS procedure codes are used for Ambulance service The HCPCS procedure codes listed in the following table are the only reimbursable pro...
-
Origin and Destination Modifier Table The modifiers listed in the following Origin and Destination Modifier table are required for billin...
-
Procedure Codes for Air Services HCPCS A0430 – Ambulance service, conventional air services, transport, one way, fixed wing Fixed Wing (F...
-
HCPCS A0432 – Paramedic Intercept (PI), rural area transport furnished by a volunteer ambulance company, which is prohibited by state law fr...
-
Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity The autonomic nervous system (ANS) regulates physiologic p...

No comments:
Post a Comment