US · guidance
CMS Pub. 100-04, ch. 4, § 20.3
Line Item Dates of Service
Where HCPCS is required a line item date of service is also required. (FL 45 on Form
CMS-1450).
The A/B MAC (A) will return claims to hospitals where a line item date of service is not
entered for each HCPCS code reported or if the line item dates of service reported are
outside of the statement-covers period.
History
(Rev. 1, 10-03-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
adb2906459f0108b97ccce038adfe5c7fd4f63308365e83bf5f92b52cb73f332
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