How To Use HCPCS Code A0998

HCPCS code A0998 describes ambulance response and treatment services that do not involve transportation. This code is used to identify situations where an ambulance is dispatched to provide medical assistance and treatment at the scene, but no transport of the patient is required. It is important for medical coders to understand the specific meaning and usage of this code to ensure accurate billing and reimbursement.

1. What is HCPCS A0998?

HCPCS code A0998 is used to identify ambulance response and treatment services that do not involve the transportation of patients. In these situations, an ambulance is dispatched to provide medical assistance and treatment at the scene, but the patient does not need to be transported to a healthcare facility. This code is typically used for cases where immediate medical attention is required, but transportation is not necessary.

2. Official Description

The official description of HCPCS code A0998 is “Ambulance response and treatment, no transport.” The short description for this code is “Ambulance response/treatment.”

3. Procedure

1. When an emergency call is received, the ambulance is dispatched to the location.
2. The ambulance arrives at the scene and the medical personnel assess the patient’s condition.
3. Treatment and medical interventions are provided to stabilize the patient’s condition.
4. If necessary, additional medical equipment and supplies are utilized during the treatment process.
5. Once the patient’s condition is stable and no further treatment is required, the ambulance personnel document the response and treatment provided.

4. When to use HCPCS code A0998

HCPCS code A0998 should be used in situations where an ambulance is dispatched to provide medical response and treatment, but no transportation of the patient is required. This code is typically used for cases where immediate medical attention is needed, but the patient’s condition does not warrant transportation to a healthcare facility. It is important to accurately document the circumstances and justification for using this code to ensure proper reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A0998, healthcare providers need to document the following:

• The reason for the ambulance response and treatment
• The specific medical interventions and treatments provided
• The duration of the response and treatment
• The outcome of the response and treatment

It is important to provide detailed documentation to support the medical necessity of the ambulance response and treatment services and to ensure accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A0998 was added to the Healthcare Common Procedure Coding System on January 01, 2006. 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. This code has been in use since its inception without any significant changes or updates.

7. Medicare and Insurance Coverage

HCPCS code A0998 is not payable by Medicare, as indicated by the coverage code I, which means it is not payable by Medicare. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is not covered, bundled, or used by Part A only. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code A0998 should be billed:

1. An ambulance is dispatched to a car accident scene where the injured individuals require immediate medical attention and treatment, but none of them need to be transported to a hospital.
2. An ambulance is called to a residential address where a patient is experiencing a severe allergic reaction. The ambulance personnel provide emergency treatment on-site, and the patient’s condition stabilizes without the need for transportation.
3. An ambulance is dispatched to a sports event where a player sustains a serious injury. The ambulance personnel provide immediate medical treatment at the scene, and the player’s condition improves, eliminating the need for transportation to a hospital.
4. An ambulance is called to a workplace where an employee collapses due to a medical emergency. The ambulance personnel provide on-site treatment, and the employee’s condition stabilizes without requiring transportation to a healthcare facility.
5. An ambulance is dispatched to a public event where several individuals experience heat exhaustion. The ambulance personnel provide treatment and medical interventions at the scene, and all individuals recover without the need for transportation.