BOx 14 and 15 of CMS 1500

Posts related Medisoft software.
Post Reply
Cler95
Posts: 5
Joined: Wed Feb 18, 2015 11:30 am

BOx 14 and 15 of CMS 1500

Post by Cler95 » Wed Feb 18, 2015 12:13 pm

Hello, this has been an ongoing issue, and I really hope you can help me with. Our claims with an auto accident injury is printing the modifier as 431, and the insurance companies are requiring a 439 modifier. According to Medisoft Help, making the "yes" response is enough to create a 439 and it is not. Everything under condition page is set as per recommended, such as the onset of injury, first day seen and type of injury as "Injury" vs (LMP or Illness). HELLLLPPP PLEASE :!:

User avatar
Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: BOx 14 and 15 of CMS 1500

Post by Gavin Walker » Wed Feb 18, 2015 2:39 pm

I think you are talking about Qualifier Code 439 on an ANSI 5010 electronic claim. You will need the Injury/Illness/LMP Date filled out with a valid date. Accident needs to be filled out with either "Yes" or "Auto". Of if "No", the Nature of Accident needs to be one of the "Injured..." selections.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

Cler95
Posts: 5
Joined: Wed Feb 18, 2015 11:30 am

Re: BOx 14 and 15 of CMS 1500

Post by Cler95 » Mon Feb 23, 2015 11:26 am

thank you, Gavin. yes, i meant the qualifier. we enter all the info in the appropraite places with date of accident as well as "injury" and "yes" to reflect this was an auto injury. On HCFA forms when printed, qualifier for box 14 results in 431 (incorrect for auto injury) and insurance companies need a 439 qualifier (even medisoft Help says an auto accident needs a 439 qualifier). Why are we getting 431 and not a 439?

Andrew
Posts: 153
Joined: Tue Mar 19, 2013 3:24 pm
Location: Springfield, MO
Contact:

Re: BOx 14 and 15 of CMS 1500

Post by Andrew » Mon Feb 23, 2015 12:29 pm

In the case, condition tab. In the Accident area it says related to: For auto you need to select Auto and not just the Yes. Yes is other accident not an auto accident.
Andrew Analla
Support Team
MedTech Medical Management Systems
3058 S Delaware Ave
Springfield, MO 65804
Ph: 417.890.6777 | Fax: 417.890.6788

Cler95
Posts: 5
Joined: Wed Feb 18, 2015 11:30 am

Re: BOx 14 and 15 of CMS 1500

Post by Cler95 » Mon Feb 23, 2015 6:47 pm

Hi Andrew. Thank you for your response. I had hoped that would fix our problem and it didn't. Is there anyt5hing else anywhere else that is resulting in 431 rather than 439?

Cler95
Posts: 5
Joined: Wed Feb 18, 2015 11:30 am

Re: BOx 14 and 15 of CMS 1500

Post by Cler95 » Tue Feb 24, 2015 9:36 am

I've been experimenting changing variables: "illness" and "injury" result in the same modifier ... it shouldn't. When LMP is enetered, modifier changes, as it should. Could this be a glitch?

Andrew
Posts: 153
Joined: Tue Mar 19, 2013 3:24 pm
Location: Springfield, MO
Contact:

Re: BOx 14 and 15 of CMS 1500

Post by Andrew » Tue Feb 24, 2015 4:38 pm

I went in to the standard 02/12 report and for the modifier in box 14 next to the date there is no way to get 439 in that field. In box 15 to get the 439 needs to have Case related to Accident marked "yes" and date of Injury illness filled out. I have attached an example of how I got the 439 to show.
Attachments
439example.PNG
439example.PNG (19.36 KiB) Viewed 8936 times
Andrew Analla
Support Team
MedTech Medical Management Systems
3058 S Delaware Ave
Springfield, MO 65804
Ph: 417.890.6777 | Fax: 417.890.6788

Cler95
Posts: 5
Joined: Wed Feb 18, 2015 11:30 am

Re: BOx 14 and 15 of CMS 1500

Post by Cler95 » Tue Feb 24, 2015 4:54 pm

Thank you.

Post Reply