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    v1.0.30
    OpenPayerBilling CodesAmbulance and Other Transport Services and SuppliesHCPCS hcpcs-a0422-ambulance-oxygen-life-sustaining
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    HCPCS Level II A0422: Ambulance Oxygen and Oxygen Supplies

    HCPCS Level II code A0422 describes ambulance-provided oxygen and oxygen supplies for life-sustaining situations, typically billed when emergency medical services deliver oxygen (ALS or BLS) during patient transport; service type: ambulance oxygen therapy; typical site of service: emergency medical transport / ambulance.

    For related coverage guidance, see recent payer policy updates: Percutaneous Arteriovenous Fistula Creation, Dialysis Services (ESRD) Coverage and Provider Requirements, Intradialytic Parenteral Nutrition - Medical Policy.

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    Clinical & Coding Specifications

    Clinical Context

    A patient with acute respiratory distress is transported by ground ambulance to the nearest emergency department. During transport the patient requires continuous supplemental oxygen delivered via nasal cannula, non-rebreather mask, or portable oxygen delivery system because of hypoxemia from conditions such as acute exacerbation of chronic obstructive pulmonary disease, pneumonia, congestive heart failure with pulmonary edema, or a life‑threatening traumatic chest injury. EMS personnel (ALS or BLS) initiate and maintain oxygen therapy, monitor oxygen saturation with pulse oximetry, adjust flow rates, and document oxygen delivery and patient response. Oxygen supplies (cylinders, tubing, masks, regulators) are provided and billed as a single ambulance supply line item when the oxygen is life‑sustaining during the transport. The clinical workflow includes pre‑transport assessment, oxygen initiation, ongoing monitoring and adjustments, handoff to ED staff with verbal report and documented oxygen flow and device, and documentation of the life‑sustaining nature of the oxygen therapy in the ambulance patient care report.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99223Initial hospital care, typically 70 minutes or moreED or inpatient physicians may perform initial evaluation after ambulance transport with life‑sustaining oxygen
    94060Bronchodilator administration and spirometry for bronchodilator responsePerformed in ED when assessing response to treatments after prehospital oxygen therapy
    94640Chemical stimulation of respiration, not performed in ambulanceRarely used; included here as a related respiratory service in emergency settings
    71020Radiologic examination, chest, single viewCommonly ordered in ED following transport to evaluate respiratory status
    94002Ventilation assist and management, initiation of non‑invasive positive pressure ventilationMay follow oxygen therapy when escalation of respiratory support is required

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    174400000X
    208VP0000X
    122400000X
    103TS0200X
    283XC2000X
    173000000X
    364SX0200X

    Related Payer Policy Updates

    Specialty: Dialysis/Renal Replacement1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Arteriovenous Fistula CreationAmeriHealth Caritas2026-08-01
    Dialysis Services (ESRD) Coverage and Provider RequirementsMississippi Division of Medicaid2026-08-01
    Intradialytic Parenteral Nutrition - Medical PolicyHealth-New-England2026-07-01
    Total Parenteral Nutrition and Intradialytic Parenteral NutritionCentene2026-05-01
    End Stage Renal Disease (ESRD): Renal Dialysispriority health2026-02-01
    Home Hemodialysis (HHD) Coverage Criteriasierra health and life2026-01-01
    Home Hemodialysis (HHD) — Coverage CriteriaUnitedHealthcare2026-01-01
    Dialysis services (acute and chronic hemodialysis and peritoneal dialysis)UnitedHealthcare2026-01-01
    Staff-Assisted Home HemodialysisCigna2025-11-15
    Parsabiv (etelcalcetide) Coverage for Secondary HyperparathyroidismMolina Healthcare2025-10-09

    Related Codes

    HCPCS-A0021-AMBULANCE-SERVICE-OUTSIDE-STATE-PER-MILE-TRANSPORT

    HCPCS A0021: Ambulance Service Outside State Per Mile, Transport (Medicaid Only)

    HCPCS-A0080-VOLUNTEER-NON-EMERGENCY-TRANSPORTATION-MILEAGE

    HCPCS Level II A0080: Non-Emergency Volunteer Vehicle Transport, Per Mile

    HCPCS-A0090-NON-EMERGENCY-TRANSPORTATION-MILE-PRIVATE-VEHICLE

    HCPCS A0090: Non-Emergency Transportation, Per Mile

    HCPCS-A0100-NON-EMERGENCY-TAXI-TRANSPORTATION

    HCPCS A0100: Non-Emergency Transportation, Taxi

    HCPCS-A0110-NON-EMERGENCY-BUS-TRANSPORTATION

    HCPCS Level II A0110: Non-Emergency Bus or Carrier Transportation

    HCPCS-A0120-NON-EMERGENCY-MINI-BUS-TRANSPORTATION

    HCPCS Level II A0120: Non‑Emergency Transportation by Mini‑Bus or Mountain Transport

    HCPCS-A0130-WHEELCHAIR-VAN-NON-EMERGENCY-TRANSPORTATION

    HCPCS Level II A0130: Non-Emergency Transportation, Wheelchair Van

    HCPCS-A0140-NON-EMERGENCY-AIR-TRANSPORTATION

    HCPCS Level II A0140: Non-Emergency Transportation and Air Travel

    HCPCS-A0160-NON-EMERGENCY-TRANSPORTATION-CASE-WORKER-SOCIAL-WORKER-PER-MILE

    HCPCS Level II A0160: Non-Emergency Transportation by Case Worker

    HCPCS-A0180-ANCILLARY-LODGING-NON-EMERGENCY-TRANSPORTATION

    HCPCS Level II A0180: Non-Emergency Transportation Lodging-Recipient

    Showing 1–10 of 40

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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