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Qualifier for Field 81 on a UB04 form


Alice Scott:
On a UB04, Field 81 Qualifier & Taxonomy Codes
Should qualifier code go in the small box after the a. and taxonomy code go
in the next box to its right
or does the combined qualifier & taxonomy go in the larger box together?
Does anything belong in the second large box in 81CC?
Thanks for your help.

The qualifier goes in the first (smaller) section of box 81 and the taxonomy code goes after it in the 1st larger section. 

At this time, the 2nd larger section does not appear to be used.  I would recommend leaving it blank.


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