Ambulance Documentation Questions – Mileage Reporting

February 08, 2017
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Ambulance Documentation Questions – Mileage Reporting

How do we record tenths of a mile when the odometer doesn’t display tenths?

Medicare billing is limited to the patient’s loaded miles only, the miles traveled while the patient is on board the ambulance. Also, “loaded mileage” must be recorded on the PCR, and billed, in increments of tenths. Unfortunately, modern ambulance odometers do not display tenths of a mile, unless the trip odometer is used.

Medicare’s Ambulance Mileage Solution…

Florida’s Medicare Carrier published the following commentary on the issue:

“Ambulance suppliers may consider measuring mileage using a separate trip odometer; however, you will still be responsible for ensuring that trip mileage is measured and reported accurately, even if you fail to reset the trip odometer at the beginning of a trip. For example, if the driver fails to reset the trip odometer at the beginning of the trip, he or she would simply document the mileage at the end of the trip and subtract the mileage for the previous trip from the total, which would leave a remaining balance that should correspond to the distance of the current trip. Tools used to measure distance traveled (such as GPS navigation equipment) are readily available to the average consumer at a low cost. As such, ambulance companies are responsible for ensuring that they have the necessary equipment to measure fractional mileage to the tenth of a mile and ensuring that onboard vehicle gauges measuring trip mileage are in working order.”

Our local Medicare carrier, Palmetto GBA published this opinion for providers in NC, SC, VA & WV:

“Regulations outlined in MLN Matters article 7065 (PDF, 63 KB) are to report mileage down to the tenth of a mile.

Most ambulance trip tickets [ePCR] have a place for the EMT or paramedic to enter/report the odometer reading at pick up and destinations locations. This information can be taken from the vehicle readings on the dash board.

If a vehicle does not have the ability to report tenths of a mile then an ambulance company can utilize a application such as MapQuest to document the mileage from pick up to destination points. If the latter is used an ambulance company should keep the documentation (print out) from the application in the medical record for that trip and submit that documentation to us if at any time we request the records for a given transport. If at any time the mileage reported to Medicare is affected by anything such as road closures and the mileage is in access of what normally would have been for that trip, such differences should be noted by EMT/paramedics and documentation should be kept on file to support the additional mileage. When we review transports we will be verifying the mileage entered on a claim with applications such as MapQuest.”

A “Good” Solution for Ambulance Mileage Reporting

The perfect solution may not exist for the ambulance industry. However, the trip odometer seems to be the most common workaround. There is no special equipment required and it will provide a tenth of a mile reading at the scene and destination both.

Remember, ambulance providers are responsible for ensuring that their mileage is recorded and billed accurately. Medicare carriers can and do use simple tools like Google Maps to verify ambulance mileage is reported properly. Regardless of the mileage reporting technique used, it would be a good idea to reduce the decision to a written company policy that stresses the method to be used and accuracy.

Great Ambulance Administrative Resources can be Found Here:

Palmetto GBA Ambulance FAQs

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