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2025 HCPCS code A0433

Ground ambulance transport with advanced life support (ALS2), including invasive interventions.

Adhere to all applicable HCPCS coding guidelines and payer-specific requirements.Accurate documentation is crucial for reimbursement.

Modifiers may apply depending on the specific circumstances of the transport and services rendered. Consult relevant modifier guidelines.

Medical necessity is established when the patient’s condition necessitates immediate transport to a hospital, and the interventions and procedures provided in the ambulance are critical for stabilizing the patient's life-threatening condition and preventing further deterioration.The necessity for ALS2 interventions must be explicitly justified.

Qualified emergency medical professionals (EMTs or paramedics) provide advanced life support interventions during transport.This includes administering medications, performing intubation, using defibrillators, and other advanced procedures as needed to stabilize the patient.

IMPORTANT For basic life support (BLS) with emergency or non-emergency transport, use codes A0426, A0427, A0428, or A0429.For services not covered by other codes, use A0999 (Unlisted ambulance service).

In simple words: This code covers emergency ambulance transport where the patient needs advanced medical care during the ride, like IV fluids, breathing support, or electric shock to the heart.It's for seriously ill or injured people requiring specialized treatment in the ambulance.

This HCPCS code represents the transportation of a patient by ground ambulance and emergency prehospital services involving invasive medical actions such as administering advanced life support interventions (intravenous fluids or drugs, intubation, cardioversion, or defibrillation), along with necessary supplies and services.The patient's condition necessitates advanced cardiac or trauma life support, including at least three separate intravenous administrations and at least one procedure from the ALS2 category (e.g., defibrillation, intubation, cardiac pacing, chest decompression).

Example 1: A patient experiencing a cardiac arrest is transported to the nearest hospital via ambulance.The EMTs perform CPR, intubate the patient, administer medications intravenously, and use a defibrillator to restore a normal heart rhythm.Code A0433 is appropriate for this scenario., A trauma patient with severe bleeding and multiple injuries is transported. The paramedics administer IV fluids, control bleeding, intubate for airway management, and provide continuous monitoring. This scenario would use code A0433 due to the advanced life support interventions., A patient with a severe allergic reaction (anaphylaxis) requires immediate transport. The EMTs administer epinephrine via IV, manage their airway, and provide oxygen support. Code A0433 is appropriate due to the invasive intervention (IV administration).

Detailed documentation must include patient’s vital signs, description of the emergency situation, all interventions and procedures performed in the ambulance (including times), medications administered with dosages, and the patient’s response to treatment.Physician orders for procedures and medications should be documented.Include arrival and departure times.

** Reimbursement for this service may involve carrier judgment due to the complexity and variability of ALS2 procedures.

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