A modifier code provides the means by which the reporting provider indicates on the claim form that a service that was provided was altered by some specific circumstance but not changed in its definition or code. When applicable, the following codes must be included on a provider's claim for ambulance, secure medical, or community transportation services:
Modifier | Description |
TK | Extra patient |
TN | Rural/outside the provider's customary service area |
QM | Hospital arranged secure medical transfer. |
S.D. Admin. R. 67:16:25:12.05
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1(1)(2)(4).