What is the ambulance modifier?
Asked by: Mrs. Eloise Hauck | Last update: December 4, 2025Score: 4.7/5 (9 votes)
What is the modifier NH for ambulance?
Each modifier consists of two characters: The first character represents the origin and the second represents the destination. For example, modifier HN means a hospital was the origin and a nursing home was the destination for the transport.
What is the modifier 76 for ambulance?
‹‹Modifier “76” (Repeat procedure or service by same physician or other qualified health care professional) may be appended to each billing code on the claims accordingly. Without this information, subsequent trips for the same recipient on the same date of service may be denied as duplicate services.››
What is the QL modifier for ambulance?
Patient pronounced dead after ambulance called. In general, if the beneficiary dies before being transported, then no Medicare payment may be made.
What is an ambulance modifier?
The modifier in the first position must describe the origin of the transport. The second letter must describe the destination. (Example: If a patient is transported from one hospital to another, the two-letter modifier submitted should be “HH” indicating a hospital-to-hospital transport).
Ambulance Modifiers
What is a GY modifier for?
GY - Statutorily Excluded Item or Service: This modifier applies when an item or service is excluded by statute and does not meet the definition of any Medicare benefit or non-Medicare insurer's contract benefit.
What is the GW modifier for ambulance?
The GW modifier indicates that the service rendered is unrelated to the patient's terminal condition. All providers must submit this modifier when the service(s) provided are unrelated to the patient's terminal condition.
What is the QN modifier for ambulance?
QN modifier is used for an Ambulance service provided directly by a provider of services.
What is the UB modifier?
UB: Used for surgical or general anesthesia related supplies and drugs, including surgical trays and plaster casting supplies, provided in conjunction with a surgical procedure code.
What is the code for ambulance?
2. National Ambulance Code (AIS-125) The National Ambulance Code, also known as AIS-125, was formulated by the Ministry of Road Transport and Highways in collaboration with the Ministry of Health and Family Welfare.
What modifier is 77?
CPT Modifier 77 'Repeat procedure by another physician': A physician may need to indicate that he or she repeated a service performed by another physician on the same day.
What is the HN modifier for ambulance billing?
HN Ambulance service origin code H (hospital) with ambulance service destination code N (skilled nursing facility) Ambulance modifier H may be used in conjunction with modifier N (H+N) to indicate transportation from an acute care hospital to a skilled nursing facility.
What is the 24 modifier?
Use CPT modifier 24 for unrelated evaluation and management service during a postoperative (global) period. The global period of a major surgery is the day prior to, day of and 90 days after the surgery.
What is an HF modifier?
Modifier HF: Substance abuse program. Indicates services provided as part of a substance abuse program. Modifier HS: Hospital-based substance abuse treatment program. Used for services provided in a hospital-based substance abuse treatment program.
Why would Medicare deny an ambulance claim?
The vast majority of Medicare denials of claims for ambulance services are “technical denials”—the services did not meet the definition of the ambulance benefit under §1861(s)(7) and regulations thereunder, viz., 42 CFR §410.40-§410.41, including certification requirements and the origin and destination requirements.
What is the J modifier for ambulance?
J: Non-hospital dialysis facility.
What is the GV modifier for?
The GV modifier is used when a physician is providing a service that is related to the diagnosis for which a patient has been enrolled in hospice.
What is a 76 modifier in medical coding?
Definitions: Modifier -76: Used to indicate that a procedure or service was repeated subsequent to the original procedure or service by the same provider ID on for the same member on the same date of service or within the post-operative period.
What is the modifier for emergency ambulance transport?
Ambulance billing uses origin and destination modifiers, such as H for Hospital, R for Residence, and N for Skilled Nursing Facility, to indicate where the transport began and ended. Additional modifiers (e.g., CR for disaster-related services) may also apply.
What is the HO and HN modifier?
The HO modifier signifies that the provider has a master's level degree and should only ever be billed if the provider has the appropriate degree level. Similarly, HN indicates a bachelor's degree level and a HP indicates a doctoral degree level.
What is the gy modifier on ambulance claims?
The GY modifier notifies the Medicare system that the service is not covered. When the claim processes, the line item with the GY modifier will deny. You will receive notification of the denial via a remittance advice notice or Medicare summary notice, and will be responsible for the charges.
What is the 59 modifier used for?
Modifier 59 Distinct Procedural Service indicates that a procedure is separate and distinct from another procedure on the same date of service. Typically, this modifier is applied to a procedure code that is not ordinarily paid separately from the first procedure but should be paid per the specifics of the situation.
What is the GG modifier used for?
HCPCS modifier GG is used to report performance and payment of a screening mammography and diagnostic mammography on the same patient on the same day. Medicare allows additional mammogram films to be performed without an additional order from the treating physician.
What is a GT modifier?
Modifiers in medical billing are two-digit codes used to provide specific details about a procedure or service provided to a patient. A GT modifier is a code used in medical billing to show administration of services through telemedicine.