Month: April 2018

Convert HIPAA 837 Dental to ADA J400 Form

This blog post describes the mapping specifications and the conversion between HIPAA 837 dental and ADA (America Dental Association) J400 in PDF format.

This was one of the 300+ pre-defined HIPAA maps that Redix International, Inc. has developed in the past 20 years. The user can integrate this map into their system with no further work.

You can test the map by going to Redix HIPAA Compliance and Conversion Demo.

A blank ADA J400 form looks like the following.

Mapping Specification

 

The ADA J400 form is using the box id to identify the meaning of each field. For example, a patient name is in box 12 and the patient date of birth is in box 13. The patient name in a HIPAA 837 dental is defined in 2010BA. Below is a table to describe the box id in the ADA J400 form and its corresponding element in HIPAA 837 dental.

Form Box IDMapping
1Checkbox Xwalked from 2300 CLM12, 19
22300 REF02 (REF01="G1" | "G3")
32010BB NM101, N3xx, N4xx
4Checkbox Xwalked by existence of 2320 loop
52330A NM103-05, 07
6Not Mapped
7DNE in HIPAA 837
82330A NM109
92320 SBR03
10Checkbox Xwalked from 2320 SBR02
112330B NM103, N3xx, N4xx
122010BA NM103-05,07, N3xx, N4xx
132010BA DMG02, converted
14Checkbox Xwalked From 2010BA DMG01
152010BA NM109
162000B SBR03
172000B SBR04
18Checkbox Xwalked From 2000B SBR02, overwritten by 2000C PAT01
19DNE in HIPAA 837
20Same as box 12 Unless Entire Set overwritten by 2010CA Equivalent
21Same as box 13 Unless overwritten by 2000CA, converted
22Checkbox Xwalked Same as box 14 unless overwritten by 2000CA
232300 CLM01
24(1-10)2300 DTP03 (DTP01="472"), overwritten by 2400 DTP03 (DTP01="472"), converted
25(1-10)2400 SV304:01
26(1-10)2400 TOO01 (first one only)
27(1-10)2400 TOO02, concatenated
28(1-10)2400 TOO03:01-05, concatenated
29(1-10)2400 SV301:02
30(1-10)2400 SV301:07
31(1-10)2400 SV307
32DNE in HIPAA 837
332300 CLM02
34Multiple mappings. "X" Xwalked from 2300 DN201
352300 NTE02, concatentated
36Xwalked from 2300 CLM09
37Xwalked from 2300 CLM08
38DNE in HIPAA 837
39Not Mapped
40Checkbox Xwalked from 2300 DN101
412300 DTP03 (DTP01="452")
422300 DN102
43Checkbox Xwalked from 2400 SV305
442400 DTP03 (DTP01="441"), converted
45Xwalked from 2300 CLM11:01-02
462300 DTP03 (DTP01="439")
472300 CLM11:04
482010AA NM103-05,07, N3xx, N4xx
492010AA NM109 (NM108="XX")
502300 REF02 (REF01="0B")
512300 REF02 (REF01="EI" | "SY")
521000A PER03 | 05 | 07 (qual="TE")
52A2300 REF02 (last one, not "0B", "EI", "SY")
53Xwalked from 2300 CLM06
54Same as box 49, unless overwritten by 2310B equivalent
55Same as box 50, unless overwritten by 2310B equivalent
562010AA N3xx, N4xx
56a2010AA PRV03, overwritten by 2310B PRV03
57Same as box 52
58Not Mapped

Some of the notes about this conversion:

  • Validates the input file. Only the file 837 is validated, the file will be converted.
  • Generates PDF file for each claim.

Example

Below is an 837 dental example:

 

ISA*00*          *00*          *ZZ*123456789012345*ZZ*123456789012345*030101*1253*^*00501*987654321*1*T*:
GS*HC*123456789012345*123456789012345*19991231*0802*123456789*X*005010X224A2
ST*837*0322*005010X224A2
BHT*0019*00*0123*20061123*1023*CH
NM1*41*1*41-LAST*41-FIRST*41-MIDDLE***46*41-46-PRIMARY
PER*IC*41-CONTACT*TE*41-TE*FX*41-FX*EM*41-EM
PER*IC*41-CONTACT*TE*41-TE*FX*41-FX*EM*41-EM
NM1*40*2*40-NAME*****46*40-46-PRIMARY
HL*1**20*1
PRV*BI*PXC*2000A-TAXONOMY
CUR*85*CAD
NM1*85*1*85-LAST*85-FIRST*85-MIDDLE***XX*1234567893
N3*85-ADDRESSLINE1*85-ADDRESSLINE2
N4*85-CITY*FL*33411
REF*EI*123456789
REF*1G*85-1G-SECONDARY
REF*0B*85-0B-SECONDARY
PER*IC*85-CONTACT*TE*85-TE*FX*85-FX*EM*85-EM
PER*IC*85-CONTACT*TE*85-TE*FX*85-FX*EM*85-EM
NM1*87*1
N3*87-ADDRESSLINE1*87-ADDRESSLINE2
N4*87-CITY*FL*33411
NM1*PE*2*PE-NAME*****PI*PE-PI-PRIMARY
N3*PE-ADDRESSLINE1*PE-ADDRESSLINE2
N4*PE-CITY*FL*33411
REF*2U*PE-2U-SECONDARY
REF*EI*123456789
HL*2*1*22*1
SBR*S********CI
NM1*IL*1*ENERST*WILLIAM***SUF*MI*IL-MI-PRIMARY
DMG*D8*19751221*M
NM1*PR*2*PLAN ABC*****PI*PR-PI-PRIMARY
N3*PR-ADDRESSLINE1*PR-ADDRESSLINE2
N4*PR-CITY*MO*64015
HL*3*2*23*0
PAT*19
NM1*QC*1*GAGA*SINGER***SUF
N3*123 APPLEWOOD LN
N4*GARDEN CITY*MO*64015
DMG*D8*19751221*M
REF*Y4*QC-Y4-SECONDARY
CLM*SMITH788*4000***11:B:1*Y*C*Y*I
DTP*439*D8*20060108
DTP*452*D8*20060108
DTP*472*D8*20060108
DTP*050*D8*20051030
DN1*36*27
DN2*8*E****JP
PWK*OZ*BM***AC*DMN0012
CN1*02*550
AMT*F5*152.45
REF*G3*13579
REF*4N*1
REF*F8*R555588
REF*9F*12345
REF*G1*13579
REF*9A*RJ55555
REF*9C*RP44444444
REF*D9*TJ98UU321
K3*STATE DATA REQUIREMENT
NTE*ADD*PATIENT IS EXTREMELY SENSITIVE TO PAIN AND REQUIRES ADDITIONAL SEDATION
HI*BK:52403*BF:52404
HCP*03*100*10*RPO12345
NM1*DN*1*SMITH*JO0HN***SUF*XX*1234567893
PRV*RF*PXC*DN-TAXONOMY
REF*0B*DN-0B-SECONDARY
REF*1G*DN-1G-SECONDARY
REF*G2*DN-G2-SECONDARY
SBR*P*01*GR00786******13
CAS*OA*93*15.06
AMT*D*411
AMT*EAF*75
AMT*A8*273
OI***Y***I
MOA***A4
NM1*IL*1*JORDAN*DALE*E**SUF*MI*IL-MI-PRIMARY
N3*IL-ADDRESSLINE1*IL-ADDRESSLINE2
N4*IL-CITY*MO*64015
NM1*PR*2*HEALTH PLAN A*****PI*PR-PI-PRIMARY
DTP*573*D8*20040203
LX*1
SV3*AD:D8080*4000****1
TOO*JP*12*L:O
DTP*472*D8*20060108
DTP*441*D8*19980401
DTP*452*D8*20040927
DTP*446*D8*20041027
DTP*196*D8*20041015
DTP*198*D8*20041029
CN1*02*550
REF*6R*54321
REF*9A*RJ55555
REF*9C*RP44444444
AMT*T*45
HCP*03*100*10*RPO12345
SE*94*0322
GE*1*123456789
IEA*1*987654321

The generated PDF file is as follows.

About Us

Redix International, Inc. is an enterprise software company. Redix develops software and provides services to help organizations convert their proprietary or organization-specific data to standardized data. Among the standardized formats supported are X12, EDIFACT, XML, NSF, UB92, HIPAA, HL7, CDA, Blue-Ribbon, FHIR, NCPDP, and PDF.

Posted by admin in HIPAA

Convert HL V2.x MFN, PPP, REF, SIU, and VXU message to FHIR

In our previous posts, we described the conversions between HL7 2.x ADT and ORU messages and FHIR STU3. This blog post explains how we convert other HL7 2.x messages to FHIR STU3 (3.0.1).  These “other” messages include the following:

  • MFN: master file – staff practitioner
  • PPP: patient pathway
  • REF: patient reference
  • SIU: scheduling information unsolicited
  • VXU: unsolicited vaccination record update

Below is a table that shows the mappings between the above HL7 2.x messages and all possible FHIR resources. Note that the section number can be changed in a different release.

HL7 2.x Message Type FHIR Resource URL Section
MFN Practitioner http://hl7.org/fhir/stu3/practitioner-mappings.html 8.4.9.2
PPP Patient http://hl7.org/fhir/stu3/patient-mappings.html 8.1.14.4
Condition http://hl7.org/fhir/stu3/condition-mappings.html 9.2.7.4
REF Patient http://hl7.org/fhir/stu3/patient-mappings.html 8.1.14.4
SIU Appointment http://hl7.org/fhir/stu3/appointment-mappings.html 12.10.9.2
Patient http://hl7.org/fhir/stu3/patient-mappings.html 8.1.14.4
VXU Patient http://hl7.org/fhir/stu3/patient-mappings.html 8.1.14.4
Immunization http://hl7.org/fhir/stu3/immunization-mappings.html 11.6.7.3
ImmunizationRecommendation http://hl7.org/fhir/stu3/immunizationrecommendation-mappings.html 11.7.7.2
MedicationAdministration http://hl7.org/fhir/stu3/medicationadministration-mappings.html 11.2.8.2

 

Some of the notes about this conversion:

  • Validates the input file. Only the file is validated, the file will be converted.
  • Generates FHIR in json format
  • Uses “bundle” as an FHIR resourceType
  • Uses “transaction” as type
  • Uses uuid for the “id” in each resource
  • Uses “urn:redix-fhir” for the identifier.system
  • Uses “PUT” method in the “request” collection. To make sure that the patient data is unique in the FHIR data server, “ifNoneExist” method is used.

You can test the conversion by going to Redix HIPAA Compliance and Conversions, and then select a file of the supported message type from your system by pressing the “Select File” button. After a file is selected, your file will be automatically converted to an FHIR message, providing the file is a valid HL7 2.x file. You will see the message type and the version number of your HL7 file. In the following example, it is SIU and V2.4, respectively.

After the conversion, you might want to upload the FHIR JSON message to your FHIR data server. The default FHIR data server is HAPI, http://fhirtest.uhn.ca/. You can press the button “Upload to FHIR Data Server” to upload your FHIR resources to the FHIR data server.

You can, of course, use your own FHIR data server. To do so, you will need to first signup and then define your data server as a default FHIR data server.

Example

Use the following SIU file as an example:

MSH|^~\&|app|sender|HL7API|PKB|201303080949||SIU^S12|ABC0000000001|P|2.4
SCH|ID123||||||^checkup^||||^^^201411201231^201411201232|||||||||||||||
NTE|||My comment|
PID|||5555555555^^^NHS^NH||Smith^John^Joe^^Mr||19700101|M|||My flat name^1, The Road^London^London^SW1A 1AA^GBR||john.smith@hotmail.com^NET~01234567890^PRN~07123456789^PRS|john.smith@company.com^NET~01234098765^WPN||||||||||||||||N|
PV1|||^^^^^^^^health centre

The above ADT message is converted to the following FHIR message in JSON, which includes three resources: Patient and Appointment.

{
  "resourceType": "Bundle",
  "type": "transaction",
  "entry": [
    {
      "resource": {
        "resourceType": "Appointment",
        "id": "3AE29201-9255-442C-986D-104E2D261444",
        "identifier": [
          {
            "system": "urn:redix-fhir",
            "value": "ID123.2014-11-20T12:31:00.2014-11-20T12:32:00"
          },
          {
            "system": "urn:originator",
            "value": "ID123"
          }
        ],
        "appointmentType": {
          "coding": [
            {
              "system": "http://example.org/appointment-type",
              "code": "checkup"
            }
          ]
        },
        "description": "My comment",
        "participant": [
          {
            "actor": {
              "reference": "Patient/3AE29223-9255-442C-986D-115E2D260101"
            }
          }
        ]
      },
      "request": {
        "method": "POST",
        "url": "appointment?identifier=redix-fhir|ID123.2014-11-20T12:31:00.2014-11-20T12:32:00"
      }
    },
    {
      "resource": {
        "resourceType": "Patient",
        "id": "67713845-5E10-4E45-9FF4-1409BEB75540",
        "identifier": [
          {
            "system": "urn:redix-fhir",
            "value": "Smith.John.male"
          },
          {
            "system": "submit_mrn",
            "value": "5555555555"
          }
        ],
        "name": [
          {
            "use": "official",
            "family": "Smith",
            "given": [
              "John"
            ],
            "suffix": "Mr"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "john.smith@hotmail.com",
            "use": "home"
          },
          {
            "system": "phone",
            "value": "john.smith@company.com",
            "use": "work"
          }
        ],
        "gender": "male",
        "birthDate": "1970-01-01",
        "deceasedBoolean": "false",
        "address": [
          {
            "use": "home",
            "line": "My flat name 1, The Road",
            "city": "London",
            "state": "London",
            "postalCode": "SW1A 1AA"
          }
        ],
        "link": [
          {
            "other": "5555555555"
          }
        ]
      },
      "request": {
        "method": "PUT",
        "url": "Patient?family=Smith&given=John&gender=male",
        "ifNoneExist": "identifier=redix-fhir|Smith.John.male"
      }
    }
  ]
}

Contact Us

We can help you to develop conversions for messages besides ADT, ORU, MFN, PPP, SIU, REF, and VXU. Feel free to reach out or connect with me at @redixfhir. We are sure that we help you to develop a conversion tool that will satisfy your requirements.

 

Posted by admin in FHIR