Effective August 1, 2013, we are expanding the ZIP code requirement for
ambulance service claims. In the September 2012 edition of
Partners in
Health UpdateSM, we informed you of the ZIP code requirement for
Medicare Advantage PPO ambulance service claims. We are expanding this
requirement so that ambulance providers will be required to include ZIP code
information on all ambulance service claims submissions, both commercial and
Medicare Advantage.
[
]Billing guidelines[
]
Please use the following guidelines based on how you submit claims for
ambulance services:
Electronic claims. If you bill electronically via HIPAA 5010, please include
both the pick-up and drop-off ZIP codes in the appropriate fields.
Paper claims. If you bill claims on paper, please include the pick-up ZIP code
in box 23 of the CMS-1500 form. The ZIP code is the only data element that
should be included in that field.
Please contact your Network Coordinator if you have any questions about this
requirement.