Trauma Team Activation Coding

For trauma team activation services to be reimbursed separately the servicing facility must be contracted with HMSA. For more information on HMSA contracting please contact your HMSA provider representative.

Billing Guidelines Effective 01/01/2021

Trauma team activation must be billed on a UB04 claim. Only facilities that are licensed/designated as trauma centers should bill trauma team activation. Providers must select the appropriate trauma level revenue code based on their trauma level license/designation.

Inpatient Claims

Payment for inpatient trauma team activation services will be recognized when revenue code 068x is billed on the claim.

Outpatient Claims

Payment for outpatient trauma team activation services will be recognized when the following is billed on the same claim:

Trauma response team HCPCS G0390 and revenue code 068x (one unit) AND

Critical care CPT 99291 and/or 99292 when applicable and revenue code 0450

Trauma Team Activation Revenue codes:

Documentation

Documentation supporting the medical necessity should be legible and maintained in the patient’s medical record and made available to HMSA upon request. Documentation must include the reason for trauma team activation. HMSA reserves the right to perform retrospective reviews on services to validate if services rendered met payment determination criteria.

Please be sure to use the most up-to-date industry-standard procedure, revenue, and diagnosis codes from the current CPT ®'', HCPCS Level II, and ICD-10-CM manuals, as recommended by the American Medical Association (AMA), the Centers for Medicare & Medicaid Services (CMS), and the American Hospital Association.

** Codes may not be all inclusive as the AMA and CMS code updates may occur more frequently.

Revision History