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Fee Schedule Line API Cannot Find Flex Code System for Procedures (Doc ID 2536407.1)

Last updated on MAY 02, 2019

Applies to:

Oracle Health Insurance Claims Adjudication - Version 3.18.3.0.0 and later
Information in this document applies to any platform.

Symptoms

Upload fee schedule lines into an existing fee schedule using the generic API using XML message:

<?xml version="1.0" encoding="UTF-8" standalone="no"?>
<feeScheduleLine enabled="true" startDate="2019-03-04">
<amount currency="AED">0</amount>
<feeSchedule code="ALL_CODES_ZERO"/>
<procedure code="0001F">
<flexCodeSystem code="CPT4"/>
</procedure>
</feeScheduleLine>

Result:

<?xml version="1.0" encoding="UTF-8"?>
<exceptionDetail xmlns:o="http://www.oracle.com/insurance/exception">
   <o:errorDetails>
       <o:errorDetail o:errorCode="GEN-HTTP-002" title="GEN-HTTP-002: LookupFailed. Could not find &amp;#34;FlexCodeSystemDomain{}&amp;#34;" o:errorPath="/procedure/flexCodeSystem"/>
   </o:errorDetails>
</exceptionDetail>

Leaving out the flexCodeSystem tag, we get:

<?xml version="1.0" encoding="UTF-8"?>
<exceptionDetail xmlns:o="http://www.oracle.com/insurance/exception">
   <o:errorDetails>
       <o:errorDetail o:errorCode="GEN-HTTP-003" title="GEN-HTTP-003: Expected single match but found &amp;#34;2&amp;#34; matches for &amp;#34;ProcedureClaimsDomain{code=0001F}&amp;#34;" o:errorPath="/procedure"/>
   </o:errorDetails>
</exceptionDetail>

Which is to be expected. So we need somehow to specify the flex code system of the procedure. Different variations were tried, but to no avail. All options combined for the procedure:

<procedure code="0001F" flexCodeSystem="CPT4" flexCodeDefinitionCode="CPT4">
     <flexCodeSystem value="CPT4" code="CPT4" id="891"/>
</procedure>

Nothing seems to work. This is something related to flexCodeSystem change in combination with the fact that generic APIonly supports one level deep FK relationship. So even though you are sending the code attribute on flexCodeSystem field. it is simply ignored.
Note that using the id (instead of the code) is not an option with a million lines to be loaded.  The same structure with the flexCodeSystem for the procedure group details works fine.


NOTE:  For the Fee Schedule Lines we switched from
using the generic API (having the issue of this SR) to the SOAP IP. So
for that particular load we have an alternative. But given the fact that
this issue is also expected for procedure group details (although not
occurring at the moment), a final solution is required.


Changes

 

Cause

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In this Document
Symptoms
Changes
Cause
Solution
References


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