We have been using OpenEMR since 2.8.3. I have upgraded accordingly in the past and we are currently running OpenEMR 4.0. I have put off implementing billing into OpenEMR until recently. I began testing billing in OpenEMR 4.0 by first processing paper claims. I discovered a minor issue when printing CMS1500 in that the justified diagnosis code was being printed twice in box 21 when 3 or less total diagnosis codes were added to the claim. I found a potential source of the error in /library/Claim.class.php and posted in the following thread.
Upon further testing I discovered that my issue is database related and not caused by code in /library/Claim.class.php. If I delete my original OpenEMR 2.8.3 “codes” table and import the “codes” table from the OpenEMR 4.0 demo, I do not have the issue of a justified diagnosis code printing twice on the CMS1500. I also noticed that my “codes” table that originated from a clean install of OpenEMR 2.8.3 contains about 26,000 rows. I tested with a separate clean installation of OpenEMR 2.8.3 and verified that the “codes” table does indeed come pre-populated with 26,000 rows of data. From OpenEMR 2.9.0 to current, the “codes” table has zero rows after clean installs. Also, my original “codes” table from OpenEMR 2.8.3 is latin1_swedish_ci. The recent “codes” table is utf8_general_ci.
For the time being, my solution is to delete my “codes” table that originated from OpenEMR 2.8.3 and bring in a clean version from OpenEMR 4.0.
Does anyone see an issue with doing this?
Does anyone have an idea why the “codes” table from OpenEMR 2.8.3 is giving me issues with CMS1500 printing in OpenEMR 4.0?
I just want to verify that I have my ducks in a row before I go live with billing. Thanks.
Hi,
In those previous versions, the icd9 codes were imported during the install. Can you check to see if those are all icd9 codes and if there are duplicates (26000 seems high, but I’m pretty clueless on the actual number of icd9 codes). On a relatively related matter, what do people think of again installing the icd9 codes at install (since we’re installing the rxnorm codes now)?
(Also, don’t worry about the character sets; that shouldn’t be causing any issues in the codes table. For release 3.1.0, converted to UTF8 encoding to support internationalization: http://www.openmedsoftware.org/wiki/OpenEMR_UTF-8_Upgrade_Howto)
-brady
For general physicians the Codes are great to have them implemented and up to date (Be it ICD9, ICD10, ICPC2 etc with some effort these are free available on the Internet and NOT copy protected). Why is there so much hesitance to implement the choice of having ICD9 or ICD 10…. does it have to do with continuity of database issues? On the surface for every New Install, to make the Code choice of the users, seem to be a matter of adaption of a a handful of files that are interrelated. But I am not a programmer………………
for a complete set of ICD9 codes. If you use the numbers they use you could end up with seemingly 99999 codes, (999.99) this includes sub-codes, but the key id number total is less because some numbers are skipped. This service seem to be a free service, could it not become a search option on the Internet like OEMR has for prescriptions at .rxlist………?
The “codes” table from a clean installation of OpenEMR 2.8.3 contains both CPT4 and HCPCS codes. The “codes” table from the OpenEMR demo site only contains ICD9 codes. In my test scenario I am using ICD9 code “722.10.” I ran a query on both “codes” table from the OpenEMR demo site and my table from OpenEMR 2.83 and both yield the same results of 24 rows and have identical table id’s 8019 to 8042.
When I print the HCFA 1500 using my “codes” table that originates from OpenEMR 2.8.3, box 21 will contain dual entries of my test diagnosis code of “722.10”. If I delete the OpenEMR 2.8.3 “codes” table and import the “codes” table from the OpenEMR demo website, the HCFA prints correctly in box 21 showing the diagnosis code of “722.10” just one time.
There are about 5,000 duplicate entries in the OpenEMR 2.8.3 “codes” table. There are about 100 that are ICD9 codes and the majority of the duplicates are HCPCS. Of the 100 duplicate ICD9 codes none are my test diagnosis code of “722.10”. There are no duplicates in the “codes” table from the OpenEMR demo site.
Could the duplicate entries in the OpenEMR 2.8.3 “codes” table be the source of my problem even though the diagnosis code I am using in testing (722.10) is not among the duplicates? This is very strange.
Hi,
Kind of odd. The demo is based off the appliance which started at version 2.8.1. However, it only has the ICD9 codes, while the sql/database.sql file from that version also included some HCPCS codes. What happens if you only yank the HCPCS items from your codes table (WHERE code_type=3).
-brady
I started looking into this again. I am testing on an upgraded OpenEMR 4.1 (previous installed version was OpenEMR 4.0) database with patch 7. Again this database originated from OpenEMR-2.8.3.
I removed records where “code_type = 3” and I yielded the same results where the justified icd9 code is showing up twice in box 21 (lines 1 & 2) of the HCFA.
However, I notice that if I save the fee sheet twice (save it and then access it again via the encounter and save it once more) before generating the HCFA 1500 there is no duplicate generated of the justified icd9 code. And if I re-open the claim and save it again there is no duplicate of the justified icd9code when I print the HCFA.
Next, I dropped my original 2.8.3 codes table and imported the codes table from the 4.1 demo site and there was no duplicate icd9 code created when generating the HCFA. Out of curiosity I dropped the codes table from the OpenEMR 4.1 demo site and imported my original 2.8.3 codes table and I was able to replicate the results. Below is a jpeg of the HCFA 1500 created with my 2.8.3 codes table from the OpenEMR 4.1 demo site. This is puzzling because my codes table has never been altered since 2.8.3 unless an update SQL along the way did something. Is is safe to say at this point this is the result of bad table data?
Solved per collaboration with Rod. Turns out there is a blank space after the ICD9 code in the code field of table codes that originates from an OpenEMR-2.8.3 installation. This additional space was causing the duplicate ICD9 code to appear on the HCFA in box 21. Solution was to:
1. Delete from codes where code_type = ‘2’;
2. Import sql/icd9-codes-insert.sql from the 4.1.0 release
