G in loop 2300 maps to > screen field?

OpenEMR Development
1

gsporter wrote on Monday, June 04, 2012:

Can anyone tell me what Item G in loop 2300 maps to > screen >field in OpenEMR?  I really like OpenEMR but I am not a programer and I can not find a map or crosswalk of the it’s fields > hcfa /X12 anywhere. 

I am doing this as a “family” project and have a hard time contacting our clearinghouse during working hours.  The problems is with Medicaid requiring a “contract code”.  Since they make up 40% of our billing I am at the point of looking at switching to one of the web based EHR systems like OfficeAlly’s if I can’t resolve it.   If OfficeAlly was rejecting it I could at least add it in at that point.   As it is OfficeAlly passes it then OK medicaid drops it into a “black hole” where we can not even access it to correct it!

Thanks for your attention to this matter,
GP

2

sunsetsystems wrote on Monday, June 04, 2012:

Don’t know what you mean by “Item G”.  Find out what segment that is, and which field in the segment.

Rod
www.sunsetsystems.com

3

yehster wrote on Monday, June 04, 2012:

Are you talking about loop 2330G “Other Payer Billing Provider”?

If so that capability doesn’t exist in OpenEMR right now (at least in X12).

From gen_x12

    // Segment NM1 (Other Payer Billing Provider) omitted.
    // Segment REF (Other Payer Billing Provider Secondary Identification) omitted.
4

gsporter wrote on Tuesday, June 05, 2012:

This is what I can pull from their documentation:

OKLAHOMA HEALTH CARE AUTHORITY -HIPAA 5010 Guidelines for Electronic Transactions – Companion Document

OKLAHOMA HIPAA 5010 ENHANCEMENT PROJECT -SYSTEM INTERFACE SPECIFICATIONS
VERSION 6.0 -837P Health Care Claim 5010 Companion Guide

Loop ID      Reference      Name                                                    Codes                              Notes/Comments

2300           NTE02              Claim Note Text                                   OKCODE                          The value is OKCODE, followed by the contract code of the Billing Provider (if applicable).
This element may also include the 9-character ZIP+4 code of the Rendering Provider when the Loop 2310B Rendering Provider Name is used. For SoonerCare purposes, the Rendering
Provider ZIP+4 code may be used to map the NPI to a legacy Provider Identifier in situations when the NPI is a one-to-many match (one NPI for more than one SoonerCare Provider ID). 
In these situations the ZIP+4 code for the physical location of the contracted Rendering Provider should be utilized. The format is shown in the following examples:
(NTE*ADD*OKCODEG) (NTE*ADD*OKCODEDM) (NTE*ADD*OKCODEG 731051234) (NTE*ADD*OKCODEDM731051234)

NOTE:
If the contract code is just one character and a ZIP+4 code is also included, the contract code must be placed in the 7th position of the NTE02 with a space in the 8th position. The format is shown in the following example:
(NTE*ADD*OKCODEG 731051234)

If no contract code is used, two spaces  must be put in positions 7 and 8 of the NTE02. The format is shown in the following example:
(NTE*ADD*OKCODE 731051234) **

They said it needs to have a value of     NTE*ADD*OKCODEG **

5

yehster wrote on Tuesday, June 05, 2012:

Misc Billing Options for HCFA-1500

The “Additional Notes” field at the bottom of “Misc Billing Options for HCFA-1500” encounter form may be what you need.

Sounds like you should put “OKCODEG” or some variation with spaces/ZIP+4/contract code in that textarea.

6

kevmccor wrote on Wednesday, June 06, 2012:

That is a very helpful answer yehster.  Few people would have known that.  I learned something and I certainly agree.  I suggest prescribed format should be followed exactly.  The NTE*ADD*  part is created by the gen_x12_837.inc.php at about line 544.  The NTE02 would be the part after NTE*ADD* and my guess is the OHCA software reads 7 characters for the “code,” a space, and the 9 character zip, beginning at character 9, interestingly.

7

gsporter wrote on Thursday, June 07, 2012:

Thanks to all of you for the input.    I tried using the “Additional Notes” field at the bottom of “Misc Billing Options for HCFA-1500”  encounter form but it was not working.   

I guess my next step is to find someone to contract to make the code changes I need.  The last code I wrote was befor C had +'s  I assume that they would be in the “gen_x12_837.inc.php” file.  Plus somewhere to input the info, maybe under
Practice | Insurance Company/Insurance Numbers That way the contract code wouldn’t have to be entered for each encounter.

If someone would be interested in this project it is something I have to do, and I would be interested in proposals/quotes.
Of course it would be put back into the common code base.

Looking at Oklahoma’s  837P HIPAA 5010 v3.0 guide

Loop 2300

Referance   Name               Codes           Notes

NTE           Claim Note Contract Code and or zip+4
NTE01        Note Referance Code        ADD,CER,DCP,DGN   Additional Information
                                                      TPO
NTE02        Claim Note Text                OKCODE                 *

*The value is OKCODE, followed by the contract code of the Billing Provider (if applicable). This element may also include the 9-character
ZIP+4 code of the Rendering Provider when the Loop 2310B Rendering Provider Name is used. For SoonerCare purposes, the Rendering Provider ZIP+4 code may be used to map the NPI to a legacy Provider Identifier in situations when the NPI is a one-to-many match  (one NPI for more than one SoonerCare Provider ID). In these situations the ZIP+4 code for the physical location of the contracted  Rendering Provider should be utilized. The format is shown in the following examples: (NTE*ADD*OKCODEG) (NTE*ADD*OKCODEDM) (NTE*ADD*OKCODEG 731051234) (NTE*ADD*OKCODEDM731051234) NOTE: If the contract code is just one character and a ZIP+4 code
is also included, the contract code must be placed in the 7th position of the NTE02 with a space in the 8th position. The format is shown in the following example: (NTE*ADD*OKCODEG 731051234) If no contract code is used, two spaces must be put in positions 7 and 8 of the NTE02. The format is shown in the following example: (NTE*ADD*OKCODE 731051234)

# There are 9 contract code but I am not sure is they are the same for all states G, T,TS, NI, A, C, DA, DC, DM
If they are they could be hard coded into a drop down.

From “gen_x12_837.inc.php” file

Looks like Loop 2300 is at line 437 -580

Lines 544 - 547 put additionalNotes //in box 19

    $out .= “NTE” .     // comments box 19
      “*” . ($CMS_5010 ? “ADD” : “”) .
      “*” . $claim->additionalNotes() .
      “~\n”;

Lines 1005 - 1008 add cptNotes // Explain Unusual Circumstances.

    $out .= “NTE” .     // Explain Unusual Circumstances.
        “*ADD” .
        “*” . $claim->cptNotecodes($prockey) .
        “~\n”;

It looks like what I need Loop 2300 NTE02 is omitted in lines 1037 and 1038

    // Segment NTE (Line Note) omitted.
    // Segment NTE (Third Party Organization Notes) omitted

Old contract information CN1 is omitted in lines 497 and 1023

Thanks for your attention to this matter,

GP

8

yehster wrote on Thursday, June 07, 2012:

Thanks to all of you for the input. I tried using the “Additional Notes” field at the bottom of “Misc Billing Options for HCFA-1500” encounter form but it was not working.

Can you provide more details about what didn’t work?  Did it not show up at all for you? or was it in the wrong place?

9

kevmccor wrote on Thursday, June 07, 2012:

It is probably beating a dead horse, but your Oklahoma guide only mentions the one segment.  What exactly is your NTE segment that was produced? Select and copy from your batch file and put it in a code block like this:

NTE*ADD*WHAT YOU ENTERED~