Attachment Triggers

Attachment Name	Level (Claim or Service Line item)	Trigger
Additional Paperwork Attached	Claim	None
Admit and Discharge	Claim	The entry of a Location Code that has an equivalent Place of Service Code of 21, 31, 51 or 61.
Ambulance	Claim and Service Line Item	The entry of any one of the following HCPCS codes: A0425, A0426, A0427, A0428, A0429, A0430, A0431, A0432, A0433, A0434, A0435, A0436, A0888.
Anesthesia Time	Service Line Item	Entry of an anesthesia procedure code that has a Type of Service of '7-Anesthesia' stored in the Procedure Code Table.
Authorization	Claim and Service Line Item	An Authorization on the patient’s account for the date of service entered.
Billing Note	Claim	None
Care Plan Oversight	Claim	The entry of G0181 or G0182 CPT codes.
Certification Number	Claim	None
Chiropractic Record	Claim	None
Claim Level Note	Claim	None
Claim Level Note (Institutional Only)	Claim	None
CMNEIP	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
CMNEPN	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
CMNO2	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
CMNOS	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
CMNPCD	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
CMNSLM	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
CMNTENS	Service Line Item	No trigger, but is required for DMERC carriers when this Certificate of Medical Necessity is needed.
Contract Information	Claim	None
Date Last Seen	Claim	None
Demonstration Project Identifier	Claim	None
EPSDT	Claim	EPSDT check box selected in the Insurance Carrier Table AND the procedure code is 99381, 99382, 99383, 99384, 99385, 99391, 99392, 99393, 99394, or 99395 AND/OR any code with the EP modifier is used.
Erythropoietin Drug Policy	Service Line Item	The entry of the Erythropoietin CPTs: J0881, J0882, J0885, J0886 and Q4081.
GBHC Code	Claim	None
Homebound Indicator	Claim	None
Immunization Batch Number	Service Line Item	None
Initial Treatment Date	Claim	None
Investigational Device Exemption Number	Claim	None
Line Item Note	Service Line Item	None
Medical Record Number	Claim	None
National Drug Code	Service Line Item	Entry of a CPT code that has an NDC Code entered for to it. Entry of a CPT code that has the NDC Required check box selected for it in the Procedure Code Table.
OB/Gyn Information	Claim	None
Outside Lab	Service Line Item	Interfaces Only - if a Modifier 90 is sent with the charge.
Patient Condition Vision	Claim	None
Patient Weight	Claim	None
Post-Op Management	Claim	Primary Insurance is Medicare and a “55” modifier is entered.
Prescription	Claim	None
Purchased Services	Service Line Item	None
Special Program Indicator	Claim and Service Line Item	None
Through Date	Service Line Item	None
UB-04 Information (5010 only)	Claim	UB Payer check box is selected in the Insurance Carrier Table for the carrier in the Ins field at the top of the Procedure Entry screen and/or by the UB Billing check box selected in the Location Code Table for the Location selected at the top of the Procedure Entry screen.