Line Beg DOS End DOS Procedure Modifier Code Type Diagnosis Units POS Specialty Amount
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To ensure the most accurate editing results, please make sure ALL fields are populated as appropriate.
MODIFER - More than one modifier can be entered in this field with the values separated by commas, no spaces. (Example: 51,59)
DIAGNOSIS - More than one diagnosis code can be entered in this field with the values separated by commas, no spaces. (Example: K635,D128)
AMOUNT - Enter a dollar amount greater than $0.00. Exact billed charges are not required, but do not leave the value at $0.00.