Not required at the time of transport. May be requested to appeal a denial from Medicare. Patient must be kept immobile because of an unstable injury with possible fracture. Suspected fractures of the upper extremities require a completed medical necessity form at the time of transfer. Suspected pelvic or lower extremity fractures do not need a medical necessity form at the time of transfer but the form may be needed to appeal a denial from Medicare.
Patient requires oxygen or other emergency treatment en route to the destination.
Oxygen alone will not guarantee approval of the claim. Restraints are needed to safely transport the patient. A completed medical necessity form is needed at the time of transport. Bed confined before and after the ambulance trip. A completed medical necessity form is needed at the time of transport.