A span date demonstrates a duration of service by reporting from and to service dates that are different from each other. For example, a rental claim without a span date would report service dates from 10/15/2019 to 10/15/2019, where the same claim with span dates might report service dates from 10/15/2019 to 11/14/2019.
In certain cases, span dates are required for proper claim processing, but they are often overused. Suppliers should understand the effect of span dates on revenue and limit their use to cases where payers explicitly require them.
Where Span Dates are Required
Medicare only requires span dates for limited products, including:
Outside of these limited products, suppliers should not use span dates for Medicare claims.
Some payers, like North Carolina Medicaid, require span dates on all rentals to avoid underpayments. On page 49 of the Medicaid and Health Choice Clinical Coverage Policy No: 5A-2 the agency provides these instructions for rental equipment:
In certain cases, span dates are required for proper claim processing, but they are often overused. Suppliers should understand the effect of span dates on revenue and limit their use to cases where payers explicitly require them.
Where Span Dates are Required
Medicare only requires span dates for limited products, including:
- Diabetic testing supplies (strips, lancets, and control solution).
- Continuous passive motion (CPM) daily rentals.
- Parenteral and enteral nutrition.
- Parenteral and enteral administration kits.
Outside of these limited products, suppliers should not use span dates for Medicare claims.
Some payers, like North Carolina Medicaid, require span dates on all rentals to avoid underpayments. On page 49 of the Medicaid and Health Choice Clinical Coverage Policy No: 5A-2 the agency provides these instructions for rental equipment:
For North Carolina Medicaid, when suppliers do not span rentals, the payer reimburses for one day of service … not the full month.
Suppliers should understand the applicable date requirements for significant payer-product combinations to avoid denials or incorrect payment amounts.
The Harm in Using Unnecessary Span Dates
For most payers, with the exception of Medicare, both the from and to service dates must be before the claim submission date. If a claim with incorrect span dates is processed on a date in between the from and to service dates, payers will likely reject the claim as a future date of service.
Suppliers commonly engage hold protocols to prevent claims from transmitting until the to date matures. In turn, claims with span dates often have to be held for 30 days longer than claims without span dates.
Additionally, payer processing systems often engage same or similar edits that look at both the from and to dates. Even when claims do not overlap, the claims processing systems often refer to the to date on the first claim and deny the second claim as too early.
Going Forward
With a full appreciation for the overall impact span dates can have, suppliers should be suspicious any time a span date is used. Evaluate all instances where span dates are utilized. When written documentation cannot be found to corroborate a payer requirement, disengage span dates for future claims. Track changes and monitor claim activity to confirm the process change doesn’t cause underpayments, rejections, or denials. By methodically weeding out unnecessary span dates, suppliers will enjoy a more expedient revenue stream with fewer rejections and denials.
SOURCE LINKS
https://www.cgsmedicare.com/jc/pubs/news/2019/05/cope12611.html
Suppliers should understand the applicable date requirements for significant payer-product combinations to avoid denials or incorrect payment amounts.
The Harm in Using Unnecessary Span Dates
For most payers, with the exception of Medicare, both the from and to service dates must be before the claim submission date. If a claim with incorrect span dates is processed on a date in between the from and to service dates, payers will likely reject the claim as a future date of service.
Suppliers commonly engage hold protocols to prevent claims from transmitting until the to date matures. In turn, claims with span dates often have to be held for 30 days longer than claims without span dates.
Additionally, payer processing systems often engage same or similar edits that look at both the from and to dates. Even when claims do not overlap, the claims processing systems often refer to the to date on the first claim and deny the second claim as too early.
Going Forward
With a full appreciation for the overall impact span dates can have, suppliers should be suspicious any time a span date is used. Evaluate all instances where span dates are utilized. When written documentation cannot be found to corroborate a payer requirement, disengage span dates for future claims. Track changes and monitor claim activity to confirm the process change doesn’t cause underpayments, rejections, or denials. By methodically weeding out unnecessary span dates, suppliers will enjoy a more expedient revenue stream with fewer rejections and denials.
SOURCE LINKS
https://www.cgsmedicare.com/jc/pubs/news/2019/05/cope12611.html
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