The Transport Justification section is where you record why the patient needed an ambulance instead of a car or a cab. For Medicare and many other payers, ambulance transport is only billable if it was medically necessary.
How to fill it in
Pick the justification that best describes why the patient could not be safely transported any other way. Common options:
- Bed-confined — the patient cannot get up or sit in a chair.
- Required cardiac monitoring during transport.
- Required oxygen during transport.
- Required IV during transport.
- Required stretcher transport for safety.
- Risk of further injury if transported by other means.
Why this matters
Medicare audits ambulance claims for medical necessity. A claim with no documented justification can be denied or even clawed back months later. Your narrative should also support whatever justification you pick — they should agree.
An example
You transport a patient with end-stage CHF on home oxygen. The patient cannot sit upright without becoming short of breath. In the Transport Justification section you check Bed-confined and Required oxygen during transport. In your narrative you mention that the patient required 4 LPM oxygen continuously and could only tolerate a semi-Fowler's position. The two pieces of documentation back each other up.