Evaluating Your Ambulance Transportation Medical Billing Procedure

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Evaluating Your Ambulance Transportation Medical
Billing Procedure

• Medical Billers and Coders

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Ambulance Transportation Medical billing has been
under the lens of Medicare for a very long time
due to the fabrication of medical charges and
unreasonable billing rates for the patients
during an emergency. In September 2015, a report
was released by the Office of Inspector General
(OIG) after studying Medicare Part B Ambulance
claims. The report clearly stated that almost 20
percent of ambulance providers have inappropriate
methods and questionable billing for ambulance
transport.
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• Medicare is worried if the gaping holes in the
  system can be identified and used to exploit the
  opportunity. The OIG identified few key points
• Ambulance Transport for beneficiaries that didnt
  receive any Medicare at the point of origin and
  destination.
• Mileage report has been towards the higher part
  for the urban areas.
• Transport levels for the destinations that arent
  covered.
• Though each of the points remains to be evaluated
  based on the patient health, transport facilities
  available in the region, and also demand for
  specialized care in case of emergency.

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Emergency vehicle administrations are secured
under Medicare Part B when outfitted to a
Medicare recipient under the conditions recorded
beneath. Real transportation of the recipient
happens. Recipient transported to a suitable
destination. Transportation by Ambulance vehicle
must be therapeutically important, i.e., the
recipients medicinal condition is with the end
goal that different types of transportation are
restoratively contraindicated. Ambulance
Transportation supplier/provider meets all
pertinent vehicles, staffing, charging, and
revealing prerequisites. Transportation isnt
viewed as a major aspect of a Part An
administration. Ambulance billing companies
across the nation need to evaluate their billing
procedures before they can control the billing
cycles. Below we give you an overview of
Ambulance Transportation Billing,
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• Claim Data Elements
• Type of Bill
• You must report the appropriate type of bill. The
  most common TOBs for ambulance services are
• 13X outpatient hospital
• 22X inpatient Part B ancillary (skilled nursing
  facility)
• 23X outpatient skilled nursing facility
• 85X outpatient CAH (critical access hospital)
• Condition code
• Report condition code B2 if you meet the CAH 35
  mile run.

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Value code/amount Report value code 32 with the
number of patients transported when transporting
more than one patient at a time to the same
destination. Report value code A0 along with the
zip code identifying the point of
pick-up. Revenue code Report revenue code 0540
on the claim for ambulance services.
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Healthcare Common Procedure Coding System
HCPCS                             Definition
A0426 Ambulance service, Advanced Life Support (ALS), non-emergency transport, Level 1
A0427 Ambulance service, ALS, emergency transport, Level 1
A0428 Ambulance service, Basic Life Support (BLS) non-emergency transport
A0429 Ambulance service, BLS, emergency transport
A0430 Ambulance service, conventional air services, transport, one way, fixed-wing
A0431 Ambulance service, conventional air services, transport, one way, rotary wing
A0432 Paramedic Intercept, rural area volunteer ambulance
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HCPCS                             Definition
A0432 Paramedic Intercept, rural area volunteer ambulance
A0433 Ambulance service, ALS, level 2
A0434 Ambulance service, specialty care transport
A0425 BLS/ALS mileage, per statute mile
A0435 Fixed-wing air mileage, per statute mile
A0436 Rotary wing air mileage, per statute mile
A0888 Mileage Beyond the Nearest Facility (noncovered)
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Ambulance Modifiers Report the most appropriate
modifier in the claim. Also, the required
documentation should be maintained before sending
in the claim. Line item dates of service You
must report the date of service on each revenue
code line.
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Units Report 1 unit with HCPCs codes A0426,
A0427, A0428, A0429, A0430, A0431, A0432, A0433,
or A0434. Report the number of loaded miles with
HCPCs codes A0425, A0435, or A0436 (mileage must
be reported as fractional units). You may round
up/down to one decimal place. The above offers
an overview of the claim filing documentation and
requirements that can be evaluated. Each
procedure and steps need to be further studied
before they can breakdown for a better procedural
task for medical billing.
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About Us Medical Billers and Coders (MBC) a
medical billing and coding company have
channelized Ambulance Transportation Medical
Billing for more than 80 facilities across United
States (US). With trained medical coders and
billers we have evaluated the situational medical
billing for ambulance transportation thats
causing losses for the facilities.
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Get in Touch

• Email info_at_medicalbillersandcoders.com
• Toll Free no 888-357-3226