5010: service and billing facilities

yehster wrote on Friday, January 06, 2012:

We ran across a 5010 issue that the current code does not seem to handle. Does anyone else have this issue? When the service location matches the billing location you should NOT have both listed. This is according to rejects we are getting from Availity. Related to NM1*77 -Tony

There is code that handles that situation. It worked for me… I generated a 5010 version of an encounter and no segment for 77 gets generated.  When I switched to 4010 and generated for the same encounter the 77 segment shows up.

Obvious question, but needs to be verified did you actually switch the drop down in X12 Partners to 5010?

  // Loop 2310D is omitted in the case of home visits (POS=12).
  if ($claim->facilityPOS() != 12 &&
      (!$CMS_5010 || $claim->facilityNPI() != $claim->billingFacilityNPI()))
    {
    ++$edicount;
    $out .= "NM1" .       // Loop 2310D Service Location
      "*77" .
      "*2";

tmccormi wrote on Friday, January 06, 2012:

And there in lies my particular problem.   This customer is submitting 4010 and letting Availity translate to 5010, however, the translate feature is weak in this area and doesn’t to this for you.  

So…  No reason (on the customer site) to keep the 4010 rule.  easy tweak.

-tony