Box 15 - Other Date

What is it?

Box 15 identifies another date related to the patient’s condition. This can be entered using the 6-digit (MMDDYY) or 8-digit (MMDDYYYY) date format. This will be identified using one of the following qualifiers:

• 304 - Last Seen
• 439 - Accident
• 454 - Initial Treatment

Enter the qualifier between the left-hand set of vertical, dotted lines.

In Application:

Note: To make this change permanent, you must update this information directly in WebPT. Otherwise, the next time you save in WebPT, the information entered there will flow over and overwrite any changes you've made.

To manually change this information:

1. Navigate to Clients > Client List.
2. Edit the desired client using the icon.
3. Select the Advanced tab.
4. Under the Dates (MM/DD/YYYY) section, enter the applicable date into the corresponding field.
5. Click Save & Close.

Note: The system will format the date into the correct format when the claim is created.

In WebPT:

To manually change this information:

1. Navigate to the desired patient's chart.
2. Select Patient Info.
3. Click the  icon for the corresponding case.
4. Use the Related Cause drop-down to make a selection.
5. If Auto Accident, Employment Injury, or Other Accident, fill out the Accident Date field.
   1. For Auto Accident, also indicate the Accident State.
6. Select OK and Save Patient.

EDI File

Loop 2300, DTP01 (Qualifier) and DTP03 (Date).