This is an unconfirmed report from the field. Anybody seen this behavior?
1) no matter how you set “Accepts assignment yes/no” on the patient’s insurance record …on box 27 of the CMS1500, Accepts assignment it renders “NO”
2) if you leave the employer blank, on the CMS 1500 it checks the 8) patient status as “Employed”
I also just noticed that when you “justify” a ICD9 code against a CPT4 code on the fee sheet, the “justified” ICD9 is printed two times in box 21 of CMS1500. If you have four ICD9 codes on the fee sheet, the one that is justified is printed twice, bumping one of the four ICD9 codes from box 21 of CMS1500. Should I put in a tracker on this? I will also be looking into this as I am in the process of getting billing set up for us in OpenEMR.
Strange, but I was only able to replicate the problem when a single diagnosis is added to the fee sheet unlike before when I had added four diagnosis codes. Several times I had added a single diagnosis code (i.e. 847.2) to the fee sheet for different patients and justified it only to discover that it was displaying two times on the CMS1500 in lines 21-1 and 21-2. This is a result of the code on line 1033 of the file /library/Claim.class.php. This loop is appending the array of “diagnosis codes” ( in this case one code - 847.2) to the array of “justified diagnosis codes” (which is also one code - 847.2). Thus it will display two times on the CMS1500.
// The above got all the diagnoses used for justification, in the order
// used for justification. Next we go through all diagnoses, justified
// or not, to make sure they all get into the claim. We do it this way
// so that the more important diagnoses appear first.
foreach ($this->diags as $diag) {
$diag = str_replace(’.’, ‘’, $diag);
$da = $diag;
}
My fix was to wrap the above loop in an “if” statement like this.
if ( (count($this->diags)) > 1 ){
foreach ($this->diags as $diag) {
$diag = str_replace(’.’, ‘’, $diag);
$da = $diag;
}
}
I figured there is no sense in adding a single diagnosis code to the array of justified diagnosis codes because it will already be present in the array of justified diagnosis codes. I will do some more testing with this.