The Additional Info sub-category holds information specifically associated with Professional claims. All of the fields under this sub-category correspond directly with fields found under the Additional Info tab within the Claim section of the application of a Professional claim.
| Name | Description |
| Claim Note | Displays the data from the Additional Info → Claim Note field on professional claims. |
| Accident State | Associated with the "Accident State" field. |
| Ambulatory Patient Group | Associated with the "Ambulatory Patient Group" field. |
| Auto Related? | Displays "Yes" if the "Is this claim auto accident related (box 10)" field is set to "Yes". Otherwise, this field will display "No". |
| Box 10-D | Associated with the "Box 10-D" field. |
| Box 19 | Associated with the "Box 19" field. |
| Delay Reason Code | Displays the chosen option in the "Delay Reason Code" combo box. |
| Demonstration Project | Associated with the "Demonstration Project' field. |
| Documentation Method | Displays the chosen option in the "Delay Reason Code" combo box. |
| Documentation Type | Displays the chosen option in the "Type" combo box next to the "Documentation Method" field. This field will display "None" if no option has been selected. |
| Employment Related? | Displays "Yes" if the "Is this claim employment related (box 10)" field is set to "Yes". Otherwise, this field will display "No". |
| GBHC Number | Associated with the "GBHC Referral Number" field. |
| Homebound? | Displays "Yes" if the "Homebound" field is set to "Yes". Otherwise, this field will display "No". |
| Investigation Device Exemption | Associated with the "Investigation Device Exemption" field. |
| Mammography Certification | Associated with the "Mammography Certification" field. |
| Other Related? | Displays "Yes" if the "Is this claim other accident related (box 10)" field is set to "Yes". Otherwise, this field will display "No". |
| Resubmit Code | Associated with the "Resubmit Reason Code (box 22)" field. |
| Service Auth. Exception | Displays the chosen option in the "Service Authorization Exception" selection field. If no selection has been made, this field will display "None". |
| Signature in Box 12? | Displays the chosen option in the "Print SIGNATURE ON FILE in Box 12" selection field. |
| Signature in Box 13? | Displays the chosen option in the "Print SIGNATURE ON FILE in Box 13" selection field. |
| Special Program Code | Displays the chosen option in the "Special Program Code" selection field. If no selection has been made, this field will display "None". |
| TPL Code | Associated with the "Payer Assigned TPL Code" field. |
| TPL Status Code | Displays the chosen option in the "TPL Status Code" selection field. If no selection has been made, this field will display "None". |
| Hospitalized Form Date | Associated with the "Hospitalized From Date (box 18)" field. |
| Hospitalized To Date | Associated with the "To Date" field next to the "Hospitalized From Date (box 18)" field. |
| Initial Treatment | Associated with the "Initial Treatment" field. |
| Last Menstrual Period | Associated with the "Last Menstrual Period" field. |
| Last Seen | Associated with the "Date Last Seen" field. |
| Onset of Illness | Associated with the "Date of Onset of Illness or Accident (box 14)" field. |
| Similar Illness | Associated with the "Date of Similar Illness (box 15)" field. |
| Unable to Work From Date | Associated with the "Unable to Work From Date (box 16)" field. |
| Unable to Work To Date | Associated with the "To Date" next to the "Unable to Work From Date (box 16)" field. |
| Patient Height | Associated with the "Height (in.)" field. |
| Patient Weight | Associated with the "Patient Weight (lbs.)" field. |
| Lab Charges | Associated with the "Lab Charges (box 20)" field. |