HCPCS Code A0435

Official Description

Fixed wing air mileage, per statute mile

Short Descr	Fixed wing air mileage
Coverage	Carrier Priced
Pricing Indicator(s)	52 – Reasonable charge
MPI	A – Not applicable, as HCPCS priced under one methodology
BETOS	O1A – Ambulance
TOS Code(s)	D – Ambulance
Added Date	1/1/2001
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Service Paid under Fee Schedule or Payment System other than OPPS
MUE	999
MUE	Not applicable/unspecified.
OTS Orthotic	No
CCS Clinical Classification	239 - Transportation - patient, provider, equipment

GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
HH	Integrated mental health/substance abuse program
GX	Notice of liability issued, voluntary under payer policy
QN	Ambulance service furnished directly by a provider of services
GZ	Item or service expected to be denied as not reasonable and necessary
HI	Integrated mental health and intellectual disability/developmental disabilities program
GA	Waiver of liability statement issued as required by payer policy, individual case
76	Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
GW	Service not related to the hospice patient's terminal condition
HS	Family/couple without client present
PI	Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing
SH	Second concurrently administered infusion therapy
ET	Emergency services
KX	Requirements specified in the medical policy have been met
LL	Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
SC	Medically necessary service or supply
HR	Family/couple with client present
RI	Ramus intermedius coronary artery