I have been using OpenEMR for some time and one of the issues that I am having problems with is ERAs that seem to upload incorrectly. This does not happen all the time but it seems to occur when the insurance company splits a CPT code into two separate lines. Has anyone encountered this problem and if so, do you have any recommendations?
Currently using 6.0.0 (1)
hi @juggernautsei , sounds like the upload is fine but the posting is creating a new entry with the split cpt with a 51 modifier added for example?
Doesn’t X12 spec allow for split segment elements with an identifier of some sort.
I seem to remember this from my days with institutional billing.
May be wrong though!
sometimes payers add additional modifiers that weren’t sent on the original claim so it’s how the posting routine handles these “new” codes
Is there anything we can do about it?
Thanks for the reply?