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Ambulance Billing Guide
- Ambulance Duplicate Claim Denials
- Ambulance Transports Included in SNF Consolidated Billing
- Ambulance Physician Certification Statement Guidelines
- Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport
- New York State Ambulance Services in Rural Areas (for JK providers only)
- Coverage of Rural Air Ambulance Services
- Ambulance Transports Excluded from SNF Consolidated Billing
- Ambulance Medical Necessity Reminder for ESRD Patients
- Related Content
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Related Articles
- Claim Denials for Medically Unnecessary Ambulance Transports: Avoiding Reason Code 55B10
- Ambulance Medical Necessity
- Ambulance Rural ZIP Code Search
- Billing for A0426 or A0428
- Medical Necessity of Ambulance Services
- Proper Claim Submission for Repetitive, Scheduled, Non-Emergent Ambulance Transports
- Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity
Billing for A0426 or A0428
National Government Services has been receiving electronic claims with the 2300 REF segment (G1 qualifier) for prior authorization, however, the value entered in REF02 is a ZIP code. This segment is intended for the UTN for RSNAT claims.
Regardless of whether your claim is for RSNAT transportation or not, the ZIP code for all ambulance claims should be placed in 2310E. The REF02 segment is solely intended for the UTN number. Claims submitted with the ZIP code in the REF02 segment will result in a denial.
For 1500 claim form submissions, the UTN is submitted in the first 14 positions in item 23. All other data submitted in item 23 must begin in position 15.
NGS is requesting ambulance suppliers work with their vendors/clearinghouse to ensure only the UTN is in the REF02 segment.
Reviewed 11/4/2024