Medicare Chapter 10 Quiz

Medicare will pay for the transport of a patient requiring services that are not available at the sending facility as long as the ambulance transport is medically necessary and the patient is being transported to the closest appropriate facility that can provide this care. This means that if a patient needs specialized medical services that are not available at the current facility, Medicare will cover the cost of transportation to the nearest facility that can provide the necessary care.

To be considered bed confined, all of the following must apply: unable to get up from bed without assistance, unable to ambulate, and unable to sit in a chair or wheelchair. This means that the individual is completely dependent on others for mobility and is unable to perform any of these activities independently.

In this scenario, the statement is stating that a "no transport situation" can be considered an exclusion under the "no transport rules" and still qualify for Medicare payment. This exception applies when the patient is declared dead after the ambulance has been dispatched to the scene but before they are loaded into the ambulance. This means that even though the patient was not transported, Medicare will still provide payment in this specific circumstance. Therefore, the answer is true.

The given statement is true. The Chapter 10 Ambulance Service Manual addresses both ground ambulance and air ambulance services. This means that air ambulance services are recognized as a valid form of ambulance transportation.

Medicare does not pay for ambulance transportation to any facility that a patient requests to be transported to. Medicare only covers ambulance transportation to the nearest appropriate medical facility that can provide the necessary care. The facility must also be participating in Medicare. Therefore, the statement is false.

The given statement is true. When we refer to locality with respect to ambulance service, we are indeed talking about the area surrounding the institution where individuals usually travel or are expected to travel to receive hospital or skilled nursing services. This refers to the immediate vicinity or nearby region where the ambulance service operates and provides medical assistance.

The Medicare Claims Processing Manual is indeed the instructional manual used for processing ambulance service claims. It provides guidance and instructions on the proper procedures and requirements for submitting and processing claims related to ambulance services under the Medicare program. Therefore, the statement is true.

Medicare does not require that the signature be obtained at the time of transport. While obtaining the signature at the time of transport is ideal, it is not a mandatory requirement for billing purposes. Medicare allows for the signature to be obtained within a reasonable timeframe after the transport has occurred. Therefore, if the signature is not obtained at the time of transport, it is still possible to bill for the services rendered.

Endotracheal intubation is considered an ALS2 service because it is a procedure that requires advanced training and skills. It involves the insertion of a tube into the trachea to establish an airway and is typically performed in emergency situations or during surgeries. Administering oxygen, IV attempts, and EKG monitoring are all important components of patient care, but they do not require the same level of expertise as endotracheal intubation. Therefore, they would not qualify for billing and payment at the ALS2 level of service.

The statement is false because a Physicians Certification Statement alone is not sufficient to prove that a non-emergency ambulance transport is medically necessary. Other supporting documentation, such as medical records, may also be required to provide evidence of the patient's condition and the need for ambulance transportation.

Physician's Office would not generally be considered a covered destination because it is not a location where medical services are provided on a long-term or specialized basis. Hospitals and Skilled Nursing Facilities are both healthcare facilities where patients receive comprehensive medical care and treatment. Beneficiary's Home refers to the patient's own residence, where healthcare services can also be provided. However, a physician's office is typically a place where patients go for routine check-ups, consultations, or minor procedures, rather than for extended or specialized care.

An EMT (Emergency Medical Technician) is not required to be contained in an ambulance to be in compliance with State and local laws. While EMTs are essential for providing medical care in an ambulance, their presence may not be required by law. The other items listed, such as sirens, stretcher, warning lights, and oxygen equipment, are typically mandated by laws to ensure the proper functioning and safety of an ambulance.