HCPCS Code A0888

Official Description

Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility)

Short Descr	Noncovered ambulance mileage
Coverage	Non-covered by Medicare
Pricing Indicator(s)	00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI	9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
MCM	2125
BETOS	O1A – Ambulance
TOS Code(s)	D – Ambulance
Added Date	1/1/1995
Status Code	Non-Covered Service
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	Non-Covered Service, not paid under OPPS
MUE	0
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
HN	Bachelors degree level
HR	Family/couple with client present
HE	Mental health program
SH	Second concurrently administered infusion therapy
GW	Service not related to the hospice patient's terminal condition
NR	New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)
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.
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.
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
EE	Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
ER	Items and services furnished by a provider-based, off-campus emergency department
GA	Waiver of liability statement issued as required by payer policy, individual case
GE	This service has been performed by a resident without the presence of a teaching physician under the primary care exception
GM	Multiple patients on one ambulance trip
GN	Services delivered under an outpatient speech language pathology plan of care
GZ	Item or service expected to be denied as not reasonable and necessary
HD	Pregnant/parenting women's program
HG	Opioid addiction treatment program
HI	Integrated mental health and intellectual disability/developmental disabilities program
HP	Doctoral level
HS	Family/couple without client present
HW	Funded by state mental health agency
KX	Requirements specified in the medical policy have been met
PN	Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
QA	Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)
QJ	Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
QL	Patient pronounced dead after ambulance called
QN	Ambulance service furnished directly by a provider of services
RE	Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)
RP	Replacement and repair -rp may be used to indicate replacement of dme, orthotic and prosthetic devices which have been in use for sometime. the claim shows the code for the part, followed by the 'rp' modifier and the charge for the part.
RR	Rental (use the 'rr' modifier when dme is to be rented)
SD	Services provided by registered nurse with specialized, highly technical home infusion training
SS	Home infusion services provided in the infusion suite of the iv therapy provider
XE	Separate encounter, a service that is distinct because it occurred during a separate encounter