Line Item Dates of Service

20.3 - Line Item Dates of Service (Rev. 1, 10-03-03) 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.