How To Use HCPCS Code A0432

HCPCS code A0432 describes the paramedic intercept (pi) service provided by a volunteer ambulance company in a rural area. This code is specifically used when the transport is furnished by a volunteer ambulance company that is prohibited by state law from billing third-party payers. In this article, we will explore the details of HCPCS code A0432, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A0432?

HCPCS code A0432 is used to identify the paramedic intercept (pi) service provided by a volunteer ambulance company in a rural area. This code is specifically applicable when the transport is furnished by a volunteer ambulance company that is prohibited by state law from billing third-party payers. It is important to note that this code is only used in specific circumstances where the ambulance company is unable to bill for their services.

2. Official Description

The official description of HCPCS code A0432 is “Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers.” The short description for this code is “Pi volunteer ambulance co.”

3. Procedure

1. The provider must first determine if the transport is being furnished by a volunteer ambulance company in a rural area.
2. Verify that the volunteer ambulance company is prohibited by state law from billing third-party payers.

4. When to use HCPCS code A0432

HCPCS code A0432 should be used when all of the following conditions are met:

• The transport is furnished by a volunteer ambulance company.
• The transport is provided in a rural area.
• The volunteer ambulance company is prohibited by state law from billing third-party payers.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A0432, healthcare providers need to ensure that the following documentation requirements are met:

• Proof that the transport was furnished by a volunteer ambulance company in a rural area.
• Evidence that the volunteer ambulance company is prohibited by state law from billing third-party payers.
• Documentation of the paramedic intercept (pi) service provided during the transport.

Providers should also follow the standard billing guidelines for ambulance services, including submitting the claim with the appropriate diagnosis codes and any other required documentation.

6. Historical Information and Code Maintenance

HCPCS code A0432 was added to the Healthcare Common Procedure Coding System on January 01, 2001. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code A0432 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code for this code is 52, which indicates that the service is priced based on a reasonable charge. The multiple pricing indicator code is A, which means it is not applicable as HCPCS is priced under one methodology.

8. Examples

Here are five examples of scenarios where HCPCS code A0432 should be billed:

1. A volunteer ambulance company in a rural area provides paramedic intercept (pi) service for a patient who requires transportation to a medical facility. The company is prohibited by state law from billing third-party payers.
2. A patient in a rural area requires urgent medical attention, and a volunteer ambulance company provides paramedic intercept (pi) service to transport the patient to the nearest hospital. The company is unable to bill third-party payers due to state law restrictions.
3. A volunteer ambulance company in a rural area provides paramedic intercept (pi) service for a patient who needs transportation to a specialized healthcare facility. The company is prohibited from billing third-party payers according to state law.
4. A patient in a rural area requires non-emergency medical transportation, and a volunteer ambulance company provides paramedic intercept (pi) service. The company is unable to bill third-party payers due to state law restrictions.
5. A volunteer ambulance company in a rural area provides paramedic intercept (pi) service for a patient who needs transportation to a rehabilitation center. The company is prohibited by state law from billing third-party payers.