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9.2.1 Emergency Ground Ambulance Transportation
When submitting ambulance claims for payment for emergency ground transportation, providers must submit HCPCS procedure codes 9-A0425 with modifier ET and 9-A0429. Ambulance providers must use an appropriate International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code on the claim form to document the client's condition and reason for the transport. If a diagnosis is not known at the time of transport, providers must code based on physical signs and symptoms of the client.
If an emergency is not indicated on the claim, the claim will be denied.
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