Medicare Rejects Diabetic Supply Claims with Improper Span Dates

Many billers learn the hard way that Medicare requires span dates for diabetic supplies … by working denials. Recently, though, many have been surprised by rejections related to supply claims that include a span date, namely spring-powered lancet devices (A4258).

While several diabetic supply items like testing strips and lancets do require span dates, the application is not universal. And in April, DME MACs began rejecting A4258 claims with different “from” and “to” dates.

Suppliers should only use span dates with three items per Medicare’s diabetic supply policy:
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• A4253 – diabetic test strips.
• A4256 – calibration control solution.
• A4259 – lancets.

Span dating refers to the requirement to report the duration of use for certain reimbursable equipment or supplies. To accommodate span dating, standard claim forms have two fields related to the date(s) of service: “from” and “to.” For products and services that require span dating, the “from” date is usually the delivery or purchase date, and the “to” date reflects the end of the time period the patient is expected to consume the supplies.

Suppliers must correct and resubmit rejected claims. To avoid future problems with similar claims, suppliers should evaluate the item and pricing configurations for spring-powered lancet devices in their billing software, and force the “to” date to match the “from” date.

SOURCE LINKS
https://cgsmedicare.com/jc/pubs/news/2022/03/cope25352.html
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55426#:~:text=DATE%20SPANS%20ON%20CLAIMS