www.MercyCareAZ.org
April 29, 2021
Billing claims for an outpatient date span 

Applicable to: Mercy Care Complete Care, Mercy Care Long Term Care, Mercy Care RBHA, Mercy Care DDD, Mercy Care DCS CHP and Mercy Care Advantage
                           
In the course of our claims review, it has been noted there have been some improper claims submissions related to billing date spans on outpatient claims. 
 
Mercy Care does accept claims billed in a date span, however, the manner in which this should be billed differs depending on the type of code billed. The National Uniform Claim Committee provides instructions on how to bill on the 1500 claim form. These instructions include the following guidance:
  • The number of days billed must correspond with the number of units in box 24G on the 1500 claim form. 
 
The following examples note the appropriate way to bill for date spans:
  • For codes that are billed in 15-minute increments, billing through a date span is not appropriate, whether the dates are consecutive or not. The number of units in box 24G do not correspond directly to the number of dates billed in the date span.
  • The claim can be billed as a multi-line claim with a line for each date with its own unique units. For example:


Mercy Care will be monitoring the submission of date span claims. Date span claims that are not appropriately billed may be subject to denial.
 
As always, don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

Thanks for all you do!

www.MercyCareAZ.org