NM182 Rendering Provider Loop needs removal

jenjhall wrote on Friday, February 10, 2012:

Hey, one local insurance company with there own electronic billing interface tells me that I am all set except that since I represent an agency that has only one provider the NPI number should only print in one spot.  That’s fine, I removed the facility NPI number but then they stated that the “NM182 Rendering Provider Loop” needs to be removed.  How do I do this? Thanks in Advance - Jen

jenjhall wrote on Tuesday, February 14, 2012:

I really need a programmer to tell me how to get this segment ~NM1*82*1******XX~PRV*PE*PXC*207Q00000X not to print in the 5010 837 file.  When the facility and the physician are one in the same this segment cannot be included in the file.  I’m desperate.  Its the rendering provider in the encounter that generates this segment.  Thanks.

jenjhall wrote on Tuesday, February 14, 2012:

I will pay $$$ - Jen

yehster wrote on Tuesday, February 14, 2012:

Jen,
Do you have more detailed guidance from the local insurance company.  (i.e. because the NPI in segment XX is the same as the NPI in segment 82 skip segment 82.)
Given that information I believe a fix could be implemented for the official code base relatively quickly.
If you would like to engage with me on this professionally
kevin.y@integralemr.com

yehster wrote on Wednesday, February 15, 2012:

https://github.com/yehster/openemr/commit/18f24d5f8bacedd2a82a17eee5c6a8333fbdc736
https://github.com/yehster/openemr/tree/soloNPI

I have implemented a fix for this with guidance from Jen as well as from the X12 Guide.
The X12 Guide says that if the provider information is the same as the facility information loop 2310B should be skipped.
It also skips segment 2310B if there is no NPI specified for the provider. (This is the case sometimes for solo practitioners who only define an NPI in facilities).

Comments appreciated.

kevmccor wrote on Thursday, February 16, 2012:

It is possible to manually delete a segment from the 837 file, but if you do, remember that the segment count in the SE segment has to be reduced.

yehster wrote on Monday, February 20, 2012:

Any feedback on this code?  If not I’m going to commit it to the master branch soon.

sunsetsystems wrote on Monday, February 20, 2012:

I made a couple of comments on github.  Otherwise it should be OK if it tests OK with other payers.

Rod
www.sunsetsystems.com

jenjhall wrote on Tuesday, February 21, 2012:

I have had success both with the original local insurance company and with Office Ally.  Thanks. - Jen

drholmes wrote on Friday, March 02, 2012:

I have a similar issue: “Facility location same as billing provider location,” rejection, Loop 2300, Segment ID: 2310C. It appears that in 4.0 I SHOULD be able to UN-CHECK the Service Location in the Edit Facility box, but when I un-check, then SAVE, the save function does not change status of the check box, and the errant loop still finds its way into the X12. Is this perhaps repaired in 4.1? Thank you in advance.

drholmes wrote on Friday, March 02, 2012:

I’m not sure why I cannot edit the Facility. I tried signing on as admin and as physician with all privileges. Unable to add a facility or edit an existing facility. Is there a “secret code” I am forgetting about?

drholmes wrote on Friday, March 02, 2012:

Update: looked at Bug Tracker, see this is an older Facility edit/add issue that may be solved by 4.0.0 update #1. Will check update status of 4.0 or get 4.1 installed ASAP.

Problem has surfaced with the 5010 rules applied to the claim by the payors (some payors continue to allow the data; some do not).

drholmes wrote on Friday, March 02, 2012:

Update: Followed Brady’s suggestion to edit in myphp. Successfully unchecked Service Facility box, but change in box status does not prevent service facility data from appearing in the X12 file (nor on the HCFA1500, box 32). I was able to make minor edits to other facility fields using myphp (made zip-code to 9-digits). BUT, still not sure how to omit the Service Facility Location information from the X12 file.

drholmes wrote on Friday, March 02, 2012:

Update: OOPS! The fee sheet did not like the missing service facility; edited service facility with myphp; billing OK now. After I USPS-mail the last of several failed x12 billings I will update to 4.1 to see if the bugs are fixed in the X12s.