CMS 1500 02/12 Box 14

Management and Administration
1

elandau1260 wrote on Tuesday, July 15, 2014:

One more question: the new form (02/12) asks for a qualifier in box 14. I notice that openEMR arbitrarily populates the qualifier of Box 14 with “431” even when there is no date in box 14. Insurance companies complain that a qualifier is present but the date was missing. Should the qualifier on my populated when there is a date? Or should the date be always filled in with the encounter date if no other accident date?

Thanks again,
-Ed

2

fsgl wrote on Thursday, July 17, 2014:

Box 15 has been eliminated & qualifier is no longer required. See .pdf, page 11.

The function of Box 15 has been merged into Box 14. If Misc Billing Options for HFCA 1500 has been saved for a charge, qualifier may show up without a date. See attachment 1.

Possible solutions:

  1. Don’t use Misc Billing Option.
  2. Try uncommenting line 345. See attachment 2.
  3. E-claim.
3

elandau1260 wrote on Thursday, July 24, 2014:

Thanks. I get solutions 2 & 3 but not #1. Where did Screenshot #1 come from? and what is “Misc Billing Option” ? I’m honestly not sure if I should do with Box 14… I just know that claims get rejected if the qualifier is there without a date.

Thanks
-Ed

4

fsgl wrote on Thursday, July 24, 2014:

Misc Billing Options is found under the Administrative tab for an encounter.

If Box 14 is not necessary for a claim and nothing has been saved in the Misc form; but qualifier appears on the CMS 1500 without human intervention, try #2.

If all else fails, submit an electronic claim instead. Other users have had problems with Box 17 as well, prompting the switch to e-claims. The format for the e-claim circumvents these difficulties.

5

blankev wrote on Thursday, July 24, 2014:

CMS patient portal, CMS Billing, CMS of OpenEMR, and reed this article:

http://www.mddionline.com/blog/devicetalk/cms-proposed-changes-take-sunshine-act-decent-idea-regulatory-madness-72314?cid=nl.mddi01

US-doctors, you live in an confusing medical professional country. How much is the Coverage in percentages of Medicare and Medicaid? IS there a CMS site where I can look up this information?

6

fsgl wrote on Thursday, July 24, 2014:

Stats.

The number for Medicare sounds correct.

Sunshine Act got an eye roll from yours truly.

7

elandau1260 wrote on Thursday, July 24, 2014:

Wow… I never even say the Administrative > Misc Billing Options… I found it but result is a blank page when I select it ??

8

fsgl wrote on Thursday, July 24, 2014:

Even if the practice never has to deal with Box 14 again, Misc form is needed for other purposes, such as visits which require a pre-authorization number. That number would be necessary for e-claims as well.

Administration/Other/Forms & check that Misc has been enabled. Misc comes pre-installed and enabled with each copy of OpenEMR. Strange.

9

fsgl wrote on Thursday, July 24, 2014:

Since Misc had been missing in action, obviously no one has used it.

Try putting a semi-colon in front of line 345 & run a test paper claim. The path in Windows is C-drive\xampp\htdocs\openemr\library\gen_hcfa_1500 .inc.php

10

yehster wrote on Thursday, July 24, 2014:

I suspect that the blank Misc Billing Options form is that the database wasn’t patched properly, and columns are missing from form_misc_billing_options