Service Facility 5010A1 error

Management and Administration
#1

drholmes wrote on Wednesday, March 07, 2012:

4.1.0, patch 7

I have checked and unchecked Service Location check-box in Facilities box, but x12 and HCFA1500 both still have the Service Facility data included. Blue Cross accepts as is but several other payors do not and payors reject the x12 claim (see below):

Error Initiator:       CONV_HIPAA                  Loop:                    2300
Segment ID:            2310C                       Element #:               NA
Version #:             5010A1                      Error Message            Service Faci
lity Location Name should not be used. Invalid data: NM1*77*2*E HOLMES PC
*****XX*134xxxxxx4~N3*1400 S. FRETZ AVE., STE. 130~N4*EDMOND*OK*73003

Any suggestions are appreciated (I have read in HELP responses that one could manually delete the segment and adjust the segment number).

Zirmed service facility location
#2

yehster wrote on Wednesday, March 07, 2012:

If the facilityNPI and the billingFacilityNPI are set to the same, segment 77 is supposed to get skipped. So if you have them set to the same in your encounter, the segment *should* be removed.

relevant code is here:

  // Loop 2310D is omitted in the case of home visits (POS=12).
  if ($claim->facilityPOS() != 12 &&
      (!$CMS_5010 || $claim->facilityNPI() != $claim->billingFacilityNPI()))
    {
    ++$edicount;
    $out .= "NM1" .       // Loop 2310D Service Location
      "*77" .
      "*2";
    //Field length is limited to 35. See nucc dataset page 77 www.nucc.org
    $facilityName = substr($claim->facilityName(), 0, $CMS_5010 ? 60 : 35);
    if ($claim->facilityName() || $claim->facilityNPI() || $claim->facilityETIN()) { $out .=
      "*" . $facilityName;
    }
#3

drholmes wrote on Wednesday, September 26, 2012:

Issue finally resolved. ANSI 837 5010A loop 2300 segment 2310C is service facility, not 2310D (was in 4010A

I finally resolved the issue: my facility (place of service) location and billing location (address) are the same and all my x-12 files were rejected by Availity due to duplication of data in the file.

The error ID is “0x3938c72, Facility location same as billing provider location”.

The error is in loop 2300, segment 2310C, Service Facility Location should no be used (because it duplicates, in my case, the billing location). By the way, the service facility location is item number (box) 32 on a 1500 form.

I have resolved the issue by the following steps in OpenEMR 4.1.0, 13:

1. Edited X-12 generation file per “yehster” to omit Loop 2310C (not 2310D) when the place of service (POS) is office (11), therefore (POS = 11) by editing the following line:

if ($claim->facilityPOS() != 11 &&

2. Not required, but I changed text in the following “notes” line to 2310C and POS=11:
// Loop 2310C is omitted in the case of office (POS=11).

3. Not required, but I changed the text in the “notes” from 2310D to 2310C.
$out .= “NM1” . // Loop 2310C Service Location

NOTE: to skip segment 2310C in loop 2300 when place of service is the office, simply change POS = 12 to POS = 11.

NOTE: The X-12 generation file has text errors; the new ANSI 837 5010A specifies the service facility location data in loop 2310C (ANSI 4010A1 Loop Identifier for service facility was 2310D).