Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Billing of date ranges for DME and specialty pharmacy

May 24, 2018

To ensure proper claims processing when billing for durable medical equipment (DME) or specialty pharmacy services, it is important to indicate the date range for which the services are being provided.

Paper claims

On the CMS-1500 (professional) claim form, in Box 24A ? Date(s) of Service, the ?From? and ?To? fields should indicate the date range for which the item is being supplied or rented.

For example, if ten units are billed for a single Current Procedural Terminology (CPT?) or Healthcare Common Procedure Coding System (HCPCS) code with only one date of service, it will be assumed that all ten units of the supply are for the single date billed and be subject to daily unit limitations. If the ten units actually represent a 30-day supply, the ?From? through ?To? dates billed should be representative of those 30 days as shown below:

Electronic claims

As a reminder, there are specific guidelines in the Independence Blue Cross HIPAA Transaction Standard Companion Guide that providers must follow when submitting electronic claims. In order to process date ranges correctly, Loop ID: 2400, Reference: DTP03 (Service Date) must be populated accordingly.

More information

For more information about paper claim submission guidelines, please refer to the 1500 Claim Form Reference Instruction Manual, which is available by selecting 1500 Instructions from the 1500 Claim Form tab on the NUCC website.

For more information about electronic claim submission guidelines, refer to the Independence Blue Cross HIPAA Transaction Standard Companion Guide, available on the Trading Partner Business Center.

CPT Copyright 2017 American Medical Association. All rights reserved. CPT? is a registered trademark of the American Medical Association.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.