Box 74a-e - Other Procedure Information

Box Definition

Box 74a-e on the UB-04 claim form is intended to display Other Procedure Information like Principal Procedure Codes.


In AveaOffice

To update Box 74a-e on the UB-04 claim form in AveaOffice:

  1. Select Create Claim Form Rule.
  2. Select the Practice.
  3. Name the rule.
  4. Select Claim Type Institutional.
  5. Select your conditions.
    Primary Behavioral Payer and HCPCS/CPT Code may be sufficient for your rule.
  6. Select behavior PCS Codes.
  7. Click Add.
  8. Enter in the PCS Code(s).
  9. Click Create.


EDI Loop/Segment

Loop 2300, Segment HI01-2

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