From and To Dates of Service on a CMS 1500
Provider Administrative Policy
DisclaimerOur provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.
Hospitalization Dates (Box 18) Service Dates (Box 24A) Use box 24G to report units for the same procedure performed multiple times for the same patient on a single date of service. If you are shipping to the patient, the date of service is the ship date. Exceptions: Procedure Codes 59425, 59426 and 77427 Monthly Services Weekly Services Daily Services
When billing consecutive "from" and "to" dates for professional service for hospitalization on a CMS 1500 form, please use the following guidelines:
When billing dates of service in Box 24A, please complete both the "from" date box (mm/dd/yyyy) and the "to" date box (mm/dd/yyyy) for each date of service. Please use only one date of service per line.
When billing for ancillary services on a monthly billing cycle, such as oxygen therapy, it is important that you bill the "from" and "to" dates in box 24A as the same date even though you are representing an entire month. Please use the earliest service date to populate those fields. For example, bill claims for the month of January with both "from" and "to" dates of 01/01/09-01/01/09 and a unit of one. Please note: If you submit a claim to Blue Cross of Idaho as a secondary policy, and the "from/through" dates are not billed per Blue Cross of Idaho guidelines, we will change the "from and through" dates to process the claim.
When billing home IV, services must be billed " from and through" dates for the total episode of care or a maximum of a 7 day span on a single line. This applies to nursing services, therapy drugs, per diems, ancillary charges and any additional services that a home IV provider would bill. For further instruction on home IV billing, please see PAP243.
When billing daily or per diem services such as enteral, home health or daily DME rentals like bililights or CPMs, it is important you bill the "from" and "to" dates in box 24 with the date span of services. For example, a claim for a CPM rental of 14 days with both "from" and "to" dates 01/01/09-01/14/09 with 14 units.
Hospitalization Dates (Box 18)
Service Dates (Box 24A)
Use box 24G to report units for the same procedure performed multiple times for the same patient on a single date of service.
If you are shipping to the patient, the date of service is the ship date.
Exceptions: Procedure Codes 59425, 59426 and 77427
|February 2013||Revised||Grammatical changes|
|September 2012||Revised||Updated language on weekly services requirements|
|January 2012||Revised||Added language regarding weekly services|
|June 2011||Revised||Added clarification|
|April 2011||Revised||Added corrected bill submission statement|
|October 2009||Revised||Per diem therapies added|
|July 2009||Revised||One date of service line added|