100-02 Medicare Benefit Policy Manual: Chapter 10 Crosswalk

Medicare Benefit Policy Manual
Chapter 10 - Ambulance Services
Crosswalk
New
Chap.
New
Sect.
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
PMs 	Description
10 	10 	A3-3114 	B3-2120,
B3-2120
HO-236 	Ambulance Service
10 	10.1 	A3-3114 	B3-2120.1 	HO-236.1 	B-00-09,
AB-00-103
Vehicle and Crew Requirement
10 	10.1.1 	A3-3114A 	B3-2120.1A 	HO-236.1A 	B-00-09,
AB-00-103
The Vehicle
10 	10.1.2 	A3-3114 	B3-2120.1 	HO-236.1 	B-00-09,
AB-00-103
Vehicle Requirements for Basic Life Support and
Advanced Life Support
10 	10.1.3 	A3-3114 	B3-2120.1C 	HO-236.1 	B-00-09,
AB-00-103
Verification of Compliance
10 	10.1.4 	A3-3114 	B3-2120.1 	HO-236.1 	B-00-09,
AB-00-103
Ambulance of Providers of Services
10 	10.1.5 	A3-3114 	B3-2120.1 	HO-236.1 	B-00-09,
AB-00-103
Equipment and Supplies
10 	10.2 	A3-3114B 	B3-2120.2 	HO-236.2 	B-01-16 	Necessity and Reasonableness
10 	10.2.1 	A3-3114B 	B3-2120.2 	HO-236.2 	B-01-16 	Necessity for the Service

New
Chap.
New
Sect.
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
PMs 	Description
10 	10.2,2 	A3-3114B 	B3-2120.2 	HO-236.2 	B-01-16 	Reasonableness of the Ambulance Trip
10 	10.2.3 	A3-3114B 	B3-2120.2 	HO-236.2 	AB-03-007 	Medicare Policy Concerning Bed-Confinement
10 	10.2.4 	AB-03-007 	Documentation Requirements
10 	10.2.5 	AB-03-007 	Transport of Persons Other Than the Beneficiary
10 	10.3 	A3-3114C 	B3-2120.3,
B3-2120.3E
HO-236.3 	The Destination
10 	10.3.1 	A3-3114C1 	HO-236.3A 	Institution to Beneficiary’s Home
10 	10.3.2 	A3-3114C2 	HO-236.3B 	Institution-to-Institution
10 	10.3.3 	A3-3114 	B3-2120 	HO-236.1 	B-00-09,
AB-00-103
Separately Payable Ambulance Transport Under
Part B versus Patient Transportation that is
Covered Under a Packaged Hospital Service
10 	10.3.4 	A3-3114C3 	B3-2120.3C 	HO-236.3C 	AB-00-127 	Round -Trip for Specialized Services
10 	10.3.5 	A3-3114C4 	B3-2120.3D 	HO-236.3D 	Partial Payment
10 	10.3.5 	A3-3114C5 	B3-2120.3E 	HO-236.3E 	Locality
10 	10.3.6 	A3-3114C6 	HO-236.3F 	Appropriate Facilities
10 	10.3.7 	A3-3114C7 	B3-2120.3G 	HO-236.3G 	Ambulance Service to Physician's Office
10 	10.3.8 	A3-3114C8 	B3-2120.3H 	HO-236.3H 	Transportation Requested by Home Health Agency
10 	10.3.9 	A3-3114C9 	B3-2120.3I 	HO-236.3I 	AB-03-007 	Coverage of Ambulance Service Furnished to
Deceased Beneficiary

New
Chap.
New
Sect.
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
PMs 	Description
Deceased Beneficiary
10 	10.3.10 	A3-3114C10 	B3-2120.3J 	Ambulance Transportation to Renal Dialysis
Facility Located on Premises of Hospital
10 	10.3.11 	B3-1726,
B3-2120.3K
AB-00-127 	Reimbursement for Ambulance Services to
Nonhospital-Based Dialysis Facilities
10 	10.3.12 	A-02-108,
B-02-060
Multiple Patient Ambulance Transport
10 	10.4 	A3-3114C11 	B3-2120.4 	HO-236.3J 	Air Ambulance Services
10 	10.4.1 	A3-3114C11A 	B3-2120.4A 	Coverage Requirements
10 	10.4.2.1 	A3-3114C11B 	Medical Appropriateness
10 	10.4.3 	A3-3114C11C 	B3-2120.4C 	Time Needed for Ground Transport
10 	10.4.4 	A3-3114C11E 	B3-2120.4E 	Hospital to Hospital Transport
10 	10.4.5 	A3-3114C11F 	B3-2120.4F 	Special Coverage Rule
10 	10.4.6 	A3-3114C11
G-H
Special Payment Limitations
10 	10.4.7 	B3-2120.4H 	Documentation
10 	10.4.8 	AB-03-007 	Air Ambulance Transports Canceled Due to
Weather or Other Circumstances Beyond the
Pilot’s Control

New
Chap.
New
Sect.
Int.
Pub. 13
Carrier
Pub. 14
HO
Pub. 10
PMs 	Description
10 	20 	B3-2125 	AB-00-103 	Coverage Guidelines for Ambulance Service
Claims
10 	20.1 	AB-03-007 	Mandatory Assignment Requirements
10 	20.1.1 	AB-03-007 	Managed Care Providers/Suppliers
10 	20.1.2 	AB-03-007 	Beneficiary Signature Requirements
10 	30 	AB-00-88,
A-01-52,
AB-01-165,
AB-02-117,
AB-02-131
Implementation of the Ambulance Fee Schedule
10 	30.1 	AB-00-88,
A-01-52
New Categories Of Ambulance Services
10 	30.1.1 	AB-00-88,
AB-02-117,
AB-02-130,
B-99-12,
B-00-01
Ground Ambulance Services
10 	30.1.2 	AB-00-88,
A-01-52
Air Ambulance Services