Medicare Claims Processing Manual (Pub. 100-04), Ch. 15 § 40
Medical Conditions List and Instructions
40 - Medical Conditions List and Instructions
(Rev. 3240, Issued: 04-24-15, Effective: 07-27-15, Implementation: 07-27-15)
See http://www.cms.gov/Center/Provider-Type/Ambulances-Services-Center.html for a medical
conditions list and instructions to assist ambulance providers and suppliers to communicate the
patient's condition to Medicare contractors, as reported by the dispatch center and as observed by
the ambulance crew. Use of the medical conditions list does not guarantee payment of the claim
or payment for a certain level of service.
In addition to reporting one of the medical conditions on the claim, one of the transportation
indicators may be included on the claim to indicate why it was necessary for the patient to be
transported in a particular way or circumstance. The provider or supplier will place the
transportation indicator in the “narrative” field on the claim. Information on the appropriate use
of transportation indicators is also available at http://www.cms.gov/Center/Provider-
Type/Ambulances-Services-Center.html