What modifiers are commonly required for ambulance or prosthetic services?

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In medical billing, modifiers are two-character codes used to provide additional information about a service or procedure. For ambulance and prosthetic services, specific modifiers are commonly required to clarify the type of service, origin/destination, or special circumstances.

Ambulance Modifiers:

Ambulance modifiers consist of two letters: the first indicates the origin, and the second indicates the destination of the transport. These are critical for billing Medicare and other payers.

Common Origin/Destination Modifiers:

• D – Diagnostic or therapeutic site other than P or H

• E – Residential, domiciliary, custodial facility

• G – Hospital-based dialysis facility

• H – Hospital

• I – Site of transfer (e.g., helicopter pad)

• J – Freestanding dialysis facility

• N – Skilled nursing facility (SNF)

• P – Physician's office

• R – Residence

• S – Scene of an accident or acute event

• X – Intermediate stop at physician’s office on the way to the hospital

Example:

• RH = Residence to Hospital

• SN = Scene to Nursing facility

Prosthetic Modifiers:

Prosthetic services often use Level II HCPCS modifiers to describe the nature of the item or fitting service.

Common Prosthetic Modifiers:

• LT – Left side

• RT – Right side

• RR – Rental

• NU – New equipment

• UE – Used equipment

Example:

• LT on a prosthetic foot code indicates it’s for the left side.

• RR on a prosthetic limb might indicate a temporary rental.

Summary:

• Ambulance: Use two-letter origin-destination codes (e.g., RH, SN).

• Prosthetics: Use modifiers like LT, RT, RR, NU, or UE to specify side, ownership, or rental status.

Correct use of modifiers ensures accurate billing and reduces the risk of claim denial.

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