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 AmeriHealth versions of the 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 appropriate HIPAA Transaction Standard Companion Guide for AmeriHealth New Jersey or AmeriHealth Pennsylvania, available on the Trading Partner Business Center.