Wiki Medicare denials for Anesthesia overnight date span

[Susan Carter CPC]

Hello Forum
We have denials from Medicare for anesthesia services that start on one date then goes overnight to the next date. Medicare is denying unprocessable MA130.
M52 missing/incomplete/invalid from date of service, M59: missing/incomplete/invalid to date of service.
They want a new claim. I cannot appeal, the claim gets dismissed. Our computer system has the fields for the start time, end time and the start date, end date. Is anyone else having problems with this issue?
If so, what are you doing to correct the issue?
Thank you

 

[LeslieJ]

Right, Medicare and other payers can't adjudicate date spans for anesthesia - time that goes from day 1 over midnight to day 2.

The good news is that our claims are billed by minutes.

Use the start date as the DOS (although the link I'm providing with Noridian says to use the END date, different payers have different rules, so watch out for that!!) - 10/1/2017-10/1/2017 and make the time 22:25-01:00 = 3 hrs 25 min or 205 minutes.

See Slide 57 & 58: https://med.noridianmedicare.com/do...entation/139f1cb5-254a-4828-9b23-0e85824d6f18

Leslie Johnson