Ambulance Codes Added to CWF Edits for SNF CB
When billing for ambulance
transports, suppliers should indicate whether the transport was
part of a SNF Part A covered stay, using the appropriate origin/destination
modifier (e.g., "NH" for a transport from a SNF to a hospital).
Suppliers should bill with an "NN" origin/destination modifier when
a SNF to SNF transport occurs. A transport between two SNFs is not
separately payable when a beneficiary is in a Part A covered SNF
stay, and will result in a denial of a claim for such a transport.
An inter-SNF transport of a beneficiary not in a Part A stay is
separately payable.
Effective August 22, 2002,
CWF will add HCPCS codes A0999, A0382, A0384, A0392, A0394, A0396,
A0398, A0420, A0422, A0424, Q3019, and Q3020 to CWF as codes subject
to SNF consolidated billing. These codes will be denied for payment
when submitted with an "NN" modifier and the beneficiary is in a
Part A covered stay. CWF will also add the additional ambulance
HCPCS codes to the bypass edit to allow claims submitted to process
and pay correctly for modifiers other than "NN" when a beneficiary
is in a Part A stay, and for claims submitted with an "NN" modifier
when the beneficiary is not in a Part A stay.
The possibility exists for
incorrect processing of claims submitted with these HCPCS codes
(except when billed with the "NN" modifier) for beneficiaries in
a Part A covered SNF stay, and for claims submitted with the "NN"
modifier when the beneficiary is not in a Part A stay. The claims
that may be affected include any submitted with the "A" HCPCS codes
listed in this notice with dates of service between April 1, 2001
and August 22, 2002, and claims submitted with HCPCS codes Q3019
or Q3020 with dates of service between April 1, 2002 and August
22, 2002. New claims submitted on or after August 23, 2002 will
process correctly. Suppliers should resubmit claims for services
processed incorrectly during this time period to their carrier for
reprocessing.
Page Last Updated: Tuesday, 04-Dec-2007 13:19:31 CST
