COT.002.228

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TMSIS Dataguide

Medicaid.gov

Version 3.38.0

ORDERING-PROV-NUM

Data Element

DE Number

COT228

System DE Number

COT.002.228

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The Medicaid provider ID of the Ordering Provider is the individual who requested the services or items being reported on this service line. Examples include, but are not limited to, provider ordering diagnostic tests and medical equipment or supplies. [Ordering provider information is only captured at the line level in the X12 837P format but in v3.0.0 of the T-MSIS file layout it is only captured at the header level. This discrepancy will be addressed in a future version of the T-MSIS OT file layout. Until Ordering provider information has been moved from the T-MSIS claim header to the line, there is no need to report it at the header.]
Size	X(30)
FLF Start Position	1539
FLF Stop Position	1568
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 30 characters or less 2. Conditional

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-7612	If a claim is a non-denied claim from an OT file, then the ORDERING-PROV-NUM value reported must be compatible with the specified T-MSIS picture format: X(30).

Measure ID	Measure Name
MIS-6-024_42	% missing: ORDERING-PROV-NUM (COT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
05/31/2023	3.8.0	COT.002.228	UPDATE	Definition	The Medicaid provider ID of the Ordering Provider is the individual who requested the services or items being reported on this service line. Examples include, but are not limited to, provider ordering diagnostic tests and medical equipment or supplies	The Medicaid provider ID of the Ordering Provider is the individual who requested the services or items being reported on this service line. Examples include, but are not limited to, provider ordering diagnostic tests and medical equipment or supplies. [Ordering provider information is only captured at the line level in the X12 837P format but in v3.0.0 of the T-MSIS file layout it is only captured at the header level. This discrepancy will be addressed in a future version of the T-MSIS OT file layout. Until Ordering provider information has been moved from the T-MSIS claim header to the line, there is no need to report it at the header.]
06/24/2022	3.0.0	COT228/ ORDERING-PROV-NUM	ADD DE	Data Dictionary - Record Layout	N/A	DE_NO\|DATA_ELEMENT_NAME\|SIZE\|FILE NAME\|FILE SEGMENT COT228\|ORDERING-PROV-NUM\|X(30)\|CLAIMOT\|CLAIM-HEADER-RECORD-OT-COT00002
06/24/2022	3.0.0	COT228	ADD	Data Dictionary	N/A	\|DE NO\| DATA ELEMENT NAME\|NECESSITY \|DEFINITION\|CODING REQUIREMENT\|FILENAME\| FILE SEGMENT NAME COT228\|ORDERING-PROV-NUM\|Conditional\|The Medicaid provider ID of the Ordering Provider is the individual who requested the services or items being reported on this service line. Examples include, but are not limited to, provider ordering diagnostic tests and medical equipment or supplies\|Value must be 30 characters or less\|CLAIMOT\|CLAIM-HEADER-RECORD-OT-COT00002