Wiki Ambulance patient transport with DR on board

[cauer]

The scenario is....we've had several cases of the H1N1 flu where 2 physicians have had to travel to the outlying hospitals to perform ECMO procedures (36822), & once the patient is stable, the DR is involved with transporting the patient by ambulance to the larger facility. We have coded those as 99082, indicating the hours of travel. We are now receiving denials from several ins carriers stating:
"Ambulance Transport Code must be a valid code".
"Ambulance Transport Reason Code must be a valid code".
"Ambulance Transport Code required when sending Transport Distance".
"Ambulance Transport Reason Code required when sending Transport Distance".

Does anyone know how to bill these transports, so the physicians can get reimbursed for the travel time involved?
Thank you!

 

[FTessaBartels]

Age of patient?

If the patient is 24 months of age or younger you can use 99466-99467.

If the patient is older ...

Encoder Pro lists 99082 with the following lay description: This code is adjunct to basic services rendered. The physician reports this code to indicate unusual travel for the purpose of transportation or accompanying the patient. This certainly seems to accurately describe your scenario. But obviously your carrier doesn't "like" it.

Have you considered using the critical care codes? The physician may be physically in an ambulance, but if the patient is on ECMO the physician is probably providing critical care during this time.

Another option might be to use the Unlisted E/M 99499 and send notes along to explain the unusual circumstances.

Also, what POS are you using?

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[cauer]

Thank you, it does help! Patient's are between the ages of 23 - 64 yrs. We're using POS 41, and agree with you on using the critical care codes. For the 99082 are we indicating that code without charges attached to it, or putting it in line 19 on HCFA as a message code?
Thanks for your help!
Cathy Auer, CPC