This Page Was Last Updated: 02 November, 2009 13:10

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CIGNA Medicare Documentation Errors

This is just to inform you CIGNA Medicare is receiving many claims for
(A0433) without the necessary documentation.  We are denying this code as a
billing error if it does not contain the necessary documentation.

If you receive a denial for code A0433, make sure that you have both 1 & 2
on the claim form or electronic narrative.  If you have not provided the
following criteria, you may re-file the claim (this can be done
electronically) as a new claim.

1.       The names of 3 drugs that were administered during preparation and
transport of the patient.
2.        At least 1 of the following ALS procedures:
*         Manual defibrillation/cardioversion
*         Endotracheal intubation
*         Central venous line
*         Cardiac pacing
*         Chest decompression
*         Surgical airway
*         Intraosseous line

There was some question as to whether the criteria is 1 and/or 2 or 1 and 2.
Our documentation from HCFA states that both are required at this time.  We
have asked for clarification but until that time, we must process claims
based on the instructions that we have at this time.

From Kim Stanley, CIGNA, 5 March 2001