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Ambulance HCPCS Codes Modifiers and Schemes

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Ambulance HCPCS Codes Modifiers and Schemes PowerPoint Presentation

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Published 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