I would like to share a notice that I recieved from Office Ally to align with ANSI X12 standards. This update enforces the required use of the Claim Frequency Code (CLM05-3) field. This field appears in Box 22 on the HCFA claim form or Box 4 on the UB claim form.
What this means for you:
Per office ally, claims submitted without a valid value in this field will be rejected with the message “Invalid Frequency Code (CLM05-3)”.
You must now explicitly provide this information when submitting claims.
Claims submitted before May 19, 2025, were not subject to this new requirement.
I suggest renaming Box 22 in openemr to be the same as the CMS 1500 form
Per the attached doc, some of the accepted codes:
1 = Original claim submission
2 = Interim – First Claim
3 = Interim – Continuing Claim
4 = Interim – Last Claim
7 = Replacement (adjustment)
8 = Void/cancel of prior claim
@moussa, thanks for the post. This is of interest to me because I am working in the billing section. Do you have any suggestions or recommendations of what needs to be done?
Hi @juggernautsei , Box 22 should be renamed from Box 22. Medicaid Resubmission Code (ICD-10):
For the other boxes, Moussa and I were talking about it here. If you save an MBO (Admin->Misc Billing Options) you’ll have some default values that are stored in the table even though there are no dates or provider entered in the mentioned fields.
Thank you for helping @juggernautsei . For this issue , we used to fill box 22 for claim adjustment. Now, I had a notice from Office Ally that they will enforce Claim Frequency Code in box 22 for all claims. This mean every claim should have a code either original, adjustment, cancel, or something else.
The issue is, it seems that if I fill anything in the form Miscellaneous Billing Options for HCFA-1500 it automaticlly add values in boxes 14, 15, and 17.
I suggest the following:
Keep boxes 14, 15, and 17 blank unless users fill them.
Renaming boxes in Miscellaneous Billing Options to match the latest CMS-1500 (attached) 1500_claim_form.pdf (251.8 KB)
Hi @juggernautsei ,
I made changes to src/Billing/MiscBillingOptions.php, library/options.inc.php, and interface/forms/misc_billing_options/new.php. This seems to fix the auto-filling of boxes 14, 15, and 17.
I will fix the naming to match the CMS-1500 wording. I was also thinking of changing boxes 10A, B, and C to be dropdown menus with “blank,” “Yes,” and “No” options to also match form CMS-1500.
Then I will create a PR and share it with you for a review
