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Ambulance HCPCS Codes Modifiers and Schemes PowerPoint Presentation

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On : Mar 14, 2014

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  • Slide 1 - October 2013 Chief Business Office Purchase Care Department of Program Integrity (DPI) Ambulance HCPCS Codes and Modifiers
  • Slide 2 - 1 Recognize Typical Ambulance Flow of Events Identify Appropriate Billing Practices Define Ambulance HCPCS Codes Describe Ambulance Modifiers Objectives
  • Slide 3 - 2 The patient has been involved in an auto accident, the ambulance transports the patient to the hospital, and the patient arrives at the hospital for treatment. Typical Flow of Events
  • Slide 4 - 3 Ambulance claim using a CMS 1500 and a hospital claim that includes both an institutional claim using a UB 04 and a professional claim using a CMS 1500. Ambulance & Hospital Claim
  • Slide 5 - 4 Table of ambulance HCPCS codes and their descriptions. Ambulance HCPCS Codes
  • Slide 6 - 5 Table of ambulance modifiers and their descriptions. Ambulance Modifiers
  • Slide 7 - 6 Ambulance claim using a CMS 1500 and a hospital claim that includes both an institutional claim using a UB 04 and a professional claim using a CMS 1500. Ambulance & Hospital Claim
  • Slide 8 - 7 Typical Ambulance Flow of Events Appropriate Ambulance Billing Practices Ambulance HCPCS Codes Ambulance Modifiers Conclusion
  • Slide 9 - 8 Veterans Affairs manages several health care programs that reimburse private health care providers for caring for our Veterans and their eligible family members. Unfortunately these health care programs have a different statutory and regulatory authority, which creates diverse payment methodologies. The majority of VA health care programs utilize Medicare’s payment methodologies or something very similar. Therefore, providers and facilities that utilize Medicare’s billing and coding guidelines will greatly minimize claim delays or rejections as a result of the Program Integrity Tools fraud and abuse review. The following Medicare link is an excellent source of billing and coding guidance for all providers and facilities: Medicare Claim Processing Guide http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c01.pdf References

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