| Parent File | Name | Number | Package | 
|---|---|---|---|
| SURGERY(#130) | OTHER PROCEDURES | 130.16 | Surgery | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | OTHER PROCEDURE | 0;1 | FREE TEXT | 
 | 
| 1.5 | PROCEDURE CODE COMMENTS | 1;0 | WORD-PROCESSING #130.26 | 
 | 
| 2 | COMPLETED | 0;3 | SET | 
 
 | 
| 3 | PLANNED OTHER PROC CPT CODE | 2;1 | POINTER TO CPT FILE (#81) | CPT(#81) 
 | 
| 4 | OTHER PROCEDURE CPT MODIFIER | MOD;0 | POINTER Multiple #130.164 | 130.164 
 | 
| 5 | OTHER ASSOC DIAGNOSIS | OADX;0 | Multiple #130.165 | 130.165 
 |