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First Coast Announces Widespread Ambulance HCPCS Code Probe

October 14, 2016 3:39 PM | Amanda Riordan (Administrator)

From the First Coast Service Options website:

First Coast Service Options Inc. (First Coast) will conduct a widespread probe (WSP) in response to an aberrant billing pattern identified for Healthcare Common Procedure Coding System (HCPCS) codes A0427 (Ambulance service, advanced life support, emergency transport, level I) and A0428 (Ambulance service, basic life support, non­emergency transport). Provider type affected specialty 59 Ambulance Company. CERT reviews indicated the errors were based on insufficient documentation to support the services billed that include missing signature, signed physician certification for the ambulance transport, and clinical documentation to support medical necessity for billed ambulance services.

First Coast will complete a WSP for dates of service February 1, 2016, to July 31, 2016, to validate the documentation supports the medical necessity and the level of ambulance service billed.

First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current.

Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.