X12 2310B Loop missing after upgrade to 5.0


#1

Hello to all:
This is my first time on this new forum, great feature showing other similar topics. I recently updated my system from 4.2.1/Ubuntu 14.04 to 5.0-3/Ubuntu 16.04. We are having a problem wherein the X12 2310A Loop is missing. This is occurring only in claims being inputted after the upgrade date. Those encounters entered prior to the update date (4/17/2017) do have the correct rendering physician and taxonomy info in 2010A Loop, and thus have been sent correctly.

Looked at Administration/Practice/Insurance numbers, to see if that could be source of the problem, but there is no change between the old instance and the new. Below shows this area just in case this may be part of the problem.

Insurance Company “Default”
Provider Number
Provider Number (Type) “OB State Licence Number”
Rendering Provider Number
Rendering Provider Number (Type) “Unspecified”
Group Number “My state license number”

Greatly appreciate your help.
Thank you,

Henry


#2

hi @hamd , so the rendering provider is missing? loop 2310B x12.php

sounds similar to recent post


#3

Hi Stephen,
Both the NM1 line and the PRV lines are not showing up. According to the X12 837p Reference - OpenEMR Project Wiki, this should be the entire 2310A Loop.
Thank you,
Henry


#4

hi @hamd, you’re original post stated [quote=“hamd, post:1, topic:8487”]
Those encounters entered prior to the update date (4/17/2017) do have the correct rendering physician and taxonomy info in 2010A Loop, and thus have been sent correctly.
[/quote]

that would be the 2310B loop
2310A is for the referring


#5

hi @hamd, i think this is the problem

do you know if the condition should apply to you? thanks


#6

Hi Stephen,
Sorry for my confusion. Yes its the 2010A Loop not 2310A. Its the rendering physician, rendering physician NPI # and other line is taxonomy # of rendering physician.

I believe the condition your referring to states the following;
If CMS_5010 X12 claim is being created and true if either provider npi is valid and both facility npi is not equal to rendering physician npi.

My npi #s are valid and My facility (group npi #) is different from my personal npi #.
Am I understanding the condition correctly?

Thank You,
Henry


#7

hi @hamd, having trouble finding 2010A in the specs. I’m guessing it is the 2310B rendering provider loop since you’re stating that’s what’s missing.


#8

Yes 2310B X12 Wiki spec sheet does have the info that my X12 is missing. Sorry to lead you astray.


#9

It’s confusing to me how encounters entered prior to upgrade have those 2 missing lines while after the upgrade they are missing.


#10

@hamd, originally was thinking it’s the gen_x12 php script that’s leaving something out but you’re stating that it’s the encounters that are the problem.

I’m unable to reproduce the error.


#11

Any ideas as to how to proceed?


#12

Is it logical to backup and reconstruct the appliance (I have it set up on a windows host / Ubuntu guest with VMWARE player)? In case there’s a glitch somewhere. The eye form doesn’t work correctly either so maybe a clean install may fix whatever’s gone array.


#13

Is it logical to check the database to see if the rendering physician and other info is there and where would I find it?


#14

hi @hamd, it should be grabbing it from the encounter form so you should see the name on that form and inside the fee sheet


#15

Hi Stephen,
Do you mean that the gen_x12 php script pulls it from the encounter form and the fee sheet itself and not from the database? The fee sheet does show the rendering physician.
Thank you,
Henry


#16

I thought that when information was entered in the fee sheet , encounter form etc that it was placed in the data base and then it was pulled from there. Am I wrong?


#17

yes, you’re right @hamd , it comes from the database but it’s expressed in the views too

is there a specific insurance company that is complaining or is it at the clearinghouse level?


#18

So far Medicare. We send claims thru Avaity to First Coast Service Options and they are going thru until we get a Medicare EOB with the error codes below; EBT’s do not show any errors, thus it seems to be that the problem is is stopping the claim at one of the last hurdles. I compared a claim batch text for the same patient with the same procedure codes and diagnosis codes before the update and after the update to determine what was different or missing and found the 2 missing lines of info, i.e. 2010B missing in the new x12 claims.

MA112=Missing/incomplete/invalid group practice information

N211= Alert you may not appeal this decision

N290= Missing/incomplete/invalid rendering provider primary identifier

Thank you,

Henry


#19

Where in the database is the rendering physician info for an encounter found. I could compare those same 2 claims to see if the info is missing in the database.
Also, I found on the forum where Brady advised to use the mysqlcheck command to check and repair the database. Might this be of help? I could run this on a copy of the appliance to see what happens.


#20

hi @hamd, it reads from form_encounter for the rendering provider[quote=“hamd, post:18, topic:8487”]
MA112=Missing/incomplete/invalid group practice information
[/quote]

the above error might suggest something that’s triggering this, could you double check your service facility under admin->facilities? thank you