Disapprove. The DSMO discourages the use of free-form text in the electronic health care claim. These types of additional supporting documentation should be sent as an attachment instead of in the claim itself. In fact, a DME attachment is under development at this time. Currently, the PWK segment should be used to indicate that a paper attachment will be sent. Furthermore, the NTE segment cannot be required by a health plan. Rather the NTE segment may be submitted by the provider when "in the opinion of the provider, the information is needed to substantiate the medical treatment and is not supported elsewhere within the claim dataset."