Prior authorization of ambulance claims requires UTN in proper field

Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a unique tracking number (UTN) is issued for each medical decision provided – whether affirmed or non-affirmed. When submitting corresponding claims, this UTN should be placed in the UTN# field. Do not place a ZIP code or any other number in this field or the claim will reject.  

For electronic 837 professional claims, the UTN field is in the 2300 – Claim Information loop or 2400 – Service Line loop in the Prior Authorization reference (REF) segment where REF01 = “G1” qualifier and REF02 = UTN.

For paper CMS 1500 Claim forms, the UTN field is in the first 14 positions in item 23. All other data submitted in item 23 must begin in position 15.