Monday, October 18, 2010

Point of pickup and what need to if area without zip code in ambulance billing

Point of Pickup (POP)

Point of pickup is the location of the beneficiary at the time he or she is placed on board the ambulance. The ZIP code of the POP must be reported on each claim for ambulance services so that the correct Geographic Adjustment Factor (GAF) and Rural Adjustment Factor (RAF) may be applied, as appropriate.

Area without a Zip Code

For areas without a zip code, it is the supplier’s responsibility to confirm that the point-of-pickup does not have a zip code that has been assigned by the U.S. Postal Service (USPS). If the supplier has made a good-faith effort to confirm that no zip code for the point-of-pickup exists, use the zip code nearest to the point of pickup.

Suppliers should document their confirmation with the USPS, or other authoritative source, that the point of pickup does not have an assigned zip code and annotate the claim to indicate that a surrogate zip code has been used (e.g., “Surrogate zip code; POP in No-Zip”). Suppliers should maintain this documentation and provide it to the carrier upon request.

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