How to enter supplemental information on BOX 24

Supplemental Information

Box 24A - 24H

�� DMAP accepts the following types of supplemental information that can be entered in the shaded line across box 24A through box 24H:

• Anesthesia duration in hours and/or minutes with start and end times
• Narrative description of unspecified codes
• National Drug Codes for drugs
• Vendor Product Number
• Health Care Uniform Code, formerly Universal Product Code
• Contract rate

�� The following qualifiers are to be used when reporting these services:

Qualifier                     Description
7                                 Anesthesia
ZZ                              Narrative description of unspecified codes
VP                              Vendor Product Number
OZ                             Health Care Uniform Code
CTR                          Contract rate
N4                             National Drug Code, also use the following:
F2                              International unit
GR                             Gram
ML                            Milliliter
UN                            Unit