Friday, October 22, 2010

Oringin and destination modifier - How to use in ambulance billing - RH AND HR

Origin and Destination Modifiers

Two single digit modifiers must


** be used with ambulance service codes to identify both the point of origin and the destination. The first single digit modifier indicates the point of origin. The second single digit modifier indicates the destination.

To avoid denial of lines of service please enter origin/destination modifiers on all lines of the claim.
This especially helps when round trips or two trips in one day occur. Each trip must be coded on a separate claim; therefore, the modifiers help us to identify the differences in the two services. The only time that CMS allows two trips to be reported on the same claim is if the zip code for the point of pick up for both trips is the same.



These single digit modifiers are defined as follows:

Modifier Description
D Diagnostic or therapeutic site other than "P" or "H" (includes free-standing facilities).
E Residential, domiciliary, custodial facility (includes non-participating facilities).
G Hospital-based dialysis facility (hospital or hospital-related).
H Hospital (includes OPD or ER)
I Site of Transfer (e.g., airport or helicopter pad) between modes of ambulance transfer
J Non hospital-based dialysis facility (free standing).
N Skilled Nursing Facility (Medicare participating only).
P Physician's office.
R Residence
S Scene of accident or acute event.
X Intermediate stop at physician's office on the way to the hospital (destination only)

Note: Modifier E applies to Assisted Living and nursing facilities.

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