| Payer | Select a payer that requires an alternate CPT4 code for the service item. This payer name prints in box 50 of the UB form. If you need to set multiple payers, fill out the information for the first payer, then select a new payer. The fields clear, but the first payer's information is saved.
Note: After a payer has been saved on the Payer tab, you cannot remove that payer if, for example, the payer is no longer valid. Instead, you must expire the payer by changing the expiration date in the Exp field.
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| Eff | Enter the date that the alternate code becomes effective. |
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| Exp | Enter the date that the alternate code for the payer ends. |
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| Form | Select either the HCFA 1500 or UB form. For more information on adding UB information, refer to the next section. |
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| Alt CPT4 | Enter the alternate CPT4 code to be used. This must be a valid CPT4 code. If an alternate code is assigned, the Service Item displays on the charge window, but the ALT code prints on the claim. |
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| Alt Payer CPT4 | Enter the alternate CPT4 code to be used for a specific payer. |
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| Location | If the practice that the SIM has access to has multiple locations, select the location to use for this payer.
Note: Set practice access from the main Service item Libraries window.
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| Alt Rev | Enter the alternate revenue code. |
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| Def Proc 1-6 | Enter the default procedure codes to assign to the SIM, which will default into the procedural diagnosis box of the charge. These are the Level III diagnostic codes printed in boxes 80 and 81 at the bottom of the UB form. |
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| Alert Message | Enter a message to display from the Charge Posting window as you add a charge for an encounter and select this SIM and a service date that falls between the effective and expiration dates for this SIM. |
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