Multipe HCFA's Per Encounter

sunsetsystems wrote on Saturday, October 01, 2005:

Has anyone noticed that a single encounter often produces multiple HCFA 1500’s?

Looking at the code in Loop.pm, it seems there is a deliberate intent to print a separate 1500 for each unique diagnosis code used in justification.  I don’t understand why this would have been done.

I noticed this in the course of working on UB-92 support.  UB-92 instructions do call for separating family planning (codes V25*) into a form by itself, so perhaps 1500’s are the same and the above was done as gross overkill?

Any enlightenment from those of you with billing experience would be greatly appreciated.

– Rod (http://www.sunsetsystems.com/)

okhra wrote on Sunday, October 02, 2005:

Hi,
I did notice this in my first week of use. It seems to be printing per page, if each procedure has a set of nonverlapping diagnoses. I didn’t have time to look through the code, and I have kind of postponed looking.may be, I didn’t know where to look :slight_smile:

In our pediatric practice, if there’s a physical and multiple immunizations, now, we generate about 3 HCFA forms, where all of them can be squeezed onto one form.

braman at world dot std dot com

sunsetsystems wrote on Wednesday, October 05, 2005:

Well I have a patch for this.  Dunno if it will break anything.  If you want to give it a try let me know.

– Rod <rod at sunsetsystems dot com>

okhra wrote on Wednesday, October 05, 2005:

Tried the new Loop.pm. Doesn’t seem to fix it. For example,
94664( 493.90 )
99214 (786.2) (493.90) 465.9) on the same encounter,
printed 2 hcfa forms.

Except for paper wastage, the Ins co seems to be handling it OK.

Thanks,
braman at world dot std dot com

sunsetsystems wrote on Wednesday, October 05, 2005:

This is just to note that okhra reports success after I sent him a correction.

Also I have a client testing this change and I’ll check it in if all goes well.

– Rod (http://www.sunsetsystems.com/)

okhra wrote on Thursday, October 06, 2005:

Sorry, I did not post here.
The fix to Loop.pm works in printing only one hcfa form.
By Friday, I should have enough volume to check it more thoroughly. I would like to stress it with more than 5 diagnoses, and see what happens, even though that case may not arise in practice.

Thanks to Rod.
braman at world dot std dot com

sunsetsystems wrote on Thursday, October 06, 2005:

The 1500 only has slots for 4 diagnoses, and I expect if you exceed that then the additional ones will not appear.  Fixing that (to the degree it’s important) would require a more detailed approach than what I’ve put into it so far.

Until then, it may be best to code a second encounter if you have more than 4 diagnoses and they are all required for justification.

– Rod (http://www.sunsetsystems.com/)

sunsetsystems wrote on Monday, October 17, 2005:

I have checked in my change to Loop.pm.  If anyone encounters a problem with it, please let me know.

– Rod (http://www.sunsetsystems.com/)