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2012 Texas Medicaid Provider Procedures Manual

Ambulance Services Handbook : 2. Ambulance Services : 2.4 Claims Filing and Reimbursement : 2.4.6 Emergency Transport Billing

Emergency transport is a benefit when billed with the ET modifier and the most appropriate emergency medical condition codes. The ET modifier must be included on every claim line in the first position.
The following procedure codes are for emergency transport:
An emergency medical condition code is required on all ambulance claims and must be listed in Box 21 of the CMS-1500 claim form.
While ICD-9-CM codes are not precluded from use on ambulance claims, they are currently not required (per the Health Insurance Portability and Accountability Act [HIPAA] of 1996) on most ambulance claims and the use of these codes generally does not trigger a payment or a denial of a claim.