Origin And Destination Modifiers
Two single digit modifiers must be used with ambulance service codes to identify both the point of origin and the destination. The first single digit modifier indicates the point of origin. The second single digit modifier indicates the destination.
These single digit modifiers are defined as follows:
D – Diagnostic or therapeutic site other than “P” or “H” (includes free-standing facilities)
E – Residential, domiciliary, custodial facility (includes non-participating facilities)
G – Hospital-based dialysis facility (hospital or hospital-related)
H – Hospital (includes OPD or ER)
I – Site of Transfer (e.g., airport or helicopter pad) between modes of ambulance transfer
J – Non hospital-based dialysis facility (free standing)
N – Skilled Nursing Facility (Medicare participating only)
P – Physician’s Office
R – Residence
S – Scene of accident or acute event
X – Immediate stop at physician’s office on the way to the hospital (destination only)
E – Residential, domiciliary, custodial facility (includes non-participating facilities)
G – Hospital-based dialysis facility (hospital or hospital-related)
H – Hospital (includes OPD or ER)
I – Site of Transfer (e.g., airport or helicopter pad) between modes of ambulance transfer
J – Non hospital-based dialysis facility (free standing)
N – Skilled Nursing Facility (Medicare participating only)
P – Physician’s Office
R – Residence
S – Scene of accident or acute event
X – Immediate stop at physician’s office on the way to the hospital (destination only)
To avoid denial of lines of service please enter origin/destination modifiers on all lines of the claim.
This especially helps when round trips or two trips in one day occur. Each trip must be coded on a separate claim, and the modifiers help identify the differences in the two services. The only time that two trips may be reported on the same claim is if the zip code for the point of pick up for both trips is the same.
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