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
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