Medicare in CA rejecting for a decimal in Diagnosis on printed HCFA's

OpenEMR Development
1

teryhill wrote on Tuesday, February 23, 2016:

Just a heads up I have a user in Calif. that is being told by Medicare that the printed HCFA is failing their scan due to the decimal in the diagnosis code. The old format 08/05 did not have the decimal point but the changes that were made to 02/12 allowed it.

Thanks

Terry

2

teryhill wrote on Wednesday, February 24, 2016:

I have a commit to fix this here

Please review and test.

Thanks

Terry

3

bradymiller wrote on Thursday, February 25, 2016:

Hi,
Hoping to get some more billing folks to check out the commit above. If no issues are brought up, then will plan to commit it to the codebase tomorrow.
-brady
OpenEMR

4

yehster wrote on Sunday, February 28, 2016:

The proposed commit does not generate what the nucc.org instructions ask for. The decimal point should be removed, not replaced with a space.

See Page 32
http://nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02-v3.pdf

Enter the codes left justified on each line to identify the patient’s diagnosis and/or condition. Do not include the decimal point in the diagnosis code, because it is implied. List no more than 12 ICD-9-CM or ICD-10-CM diagnosis codes. Relate lines A - L to the lines of service in 24E by the letter of the line. Use the greatest level of specificity. Do not provide narrative description in this field.

There is an image in the PDF as well, showing the proper formatting.

Not including the decimal point is a new change in version 3 of the NUCC instructions.

5

yehster wrote on Sunday, February 28, 2016:

The version 1.1 of the instruction which the original code was based on still included the decimal point. (See page 32 again…)

http://nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02.pdf

Looking at the changes from version 2 to 3 and making sure the code is in compliance would be a good task.

http://nucc.org/images/stories/PDF/instruction_manual_change_log_v3_01-2016.pdf

Haven’t found the change log for version 1.1. to 2 yet.

6

teryhill wrote on Sunday, February 28, 2016:

Thanks Kevin I will look or the 2 to 3 change document. I will post a commit removing the space.
Terry

7

teryhill wrote on Sunday, February 28, 2016:

Thanks Kevin I will look or the 2 to 3 change document. I will post a commit removing the space.
Terry

8

fsgl wrote on Sunday, February 28, 2016:

See page 32 of version 2.0 & page 15 of attachment.

9

fsgl wrote on Sunday, February 28, 2016:

CMS paper claim guide, revised on 8/6/15, page 15, with same instructions as attachment above.

10

bradymiller wrote on Tuesday, March 01, 2016:

Hi Terry,
i just committed your fix(including the commit removing the space).
Thanks for the contribution!
-brady