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Ambulance Claims Submitted for Mileage
Information posted October 8, 2009: TMHP has identified an issue that impacts ambulance claims submitted with dates of service on or after September 1, 2009 through October 2, 2009, and mileage procedure code A0425 with an advanced life support (ALS) or specialty care transport (SCT) procedure code A0426, A0427, A0433, or A0434. These claims may have been denied in error with an explanation of benefits (EOB) that indicated the mileage procedure code is part of another procedure or service billed on the same day.
Effective for dates of service on or after September 1, 2009, ALS and SCT procedure codes A0398, A0426, A0427, A0433, and A0434 may be reimbursed in the independent laboratory (place of service [POS] 6), birthing center (POS 7), or other location (POS 9) setting.
Affected claims will be reprocessed, and payments will be adjusted accordingly. No action on the part of the provider is necessary.
For more information, call the TMHP Contact Center at 1-800-925-9126.
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