HCPCS Code A0999

Official Description

Unlisted ambulance service

Short Descr	Unlisted ambulance service
Coverage	Special coverage instructions apply
Pricing Indicator(s)	57 – Other carrier priced
MPI	A – Not applicable, as HCPCS priced under one methodology
MCM	2120.1
BETOS	O1A – Ambulance
TOS Code(s)	D – Ambulance
Added Date	1/1/1987
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	1
MUE	Not applicable/unspecified.
IOM	100-02, 10, 20
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
HN	Bachelors degree level
HH	Integrated mental health/substance abuse program
RR	Rental (use the 'rr' modifier when dme is to be rented)
SH	Second concurrently administered infusion therapy
HR	Family/couple with client present
HE	Mental health program
QN	Ambulance service furnished directly by a provider of services
GW	Service not related to the hospice patient's terminal condition
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.
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
SS	Home infusion services provided in the infusion suite of the iv therapy provider
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.
HS	Family/couple without client present
HP	Doctoral level
PN	Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
HI	Integrated mental health and intellectual disability/developmental disabilities program
NR	New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)
77	Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 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)
CR	Catastrophe/disaster related
EP	Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program
ER	Items and services furnished by a provider-based, off-campus emergency department
GM	Multiple patients on one ambulance trip
GZ	Item or service expected to be denied as not reasonable and necessary
HD	Pregnant/parenting women's program
HG	Opioid addiction treatment program
LT	Left side (used to identify procedures performed on the left side of the body)
PS	Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy
QL	Patient pronounced dead after ambulance called
RD	Drug provided to beneficiary, but not administered "incident-to"
RE	Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)
RI	Ramus intermedius coronary artery
SE	State and/or federally-funded programs/services
U1	Medicaid level of care 1, as defined by each state
U2	Medicaid level of care 2, as defined by each state
U8	Medicaid level of care 8, as defined by each state
UC	Medicaid level of care 12, as defined by each state
UJ	Services provided at night
XE	Separate encounter, a service that is distinct because it occurred during a separate encounter