TPL.004.058

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TMSIS Dataguide

Medicaid.gov

Version 3.38.0

COVERAGE-TYPE

Data Element

DE Number

TPL058

System DE Number

TPL.004.058

File Name

TPL - THIRD-PARTY LIABILITY

File Segment Number

File Segment Name

TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Code indicating the level of coverage being provided under this policy for the insured by the TPL carrier.
Size	X(2)
FLF Start Position	56
FLF Stop Position	57
Segment Key Field Identifier	4
Coding Requirements	1. Value must be in Coverage Type List (VVL) 2. Value must be 2 characters 3. Mandatory

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

RULE ID	RULE Definition
RULE-3123	If the coverage type is populated on a TPL medicaid eligible person health insurance coverage information file, then the coverage type reported must be found in the list of valid values.
RULE-6655	If a segment is a TPL medicaid eligible person health insurance coverage categories segment from a TPL file, the coverage type value reported must be compatible with the specified T-MSIS picture format: X(2).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
TPL089	TPL.003.089	COVERAGE-TYPE	TPL00003	TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	TPL.004.058	UPDATE	Coding requirement	1. Value must be in Coverage Type List (VVL).2. Value must be 2 characters3. Mandatory	1. Value must be in Coverage Type List (VVL)2. Value must be 2 characters3. Mandatory
09/21/2023	3.13.0	TPL.004.058	UPDATE	Segment key field identifier	Not Applicable	4
06/24/2022	3.0.0	COVERAGE-TYPE	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME DEFINITION\| \|TPL058\|COVERAGE-TYPE\|This code identifies the relationship of the policy holder to the Medicaid/CHIP beneficiary. see Policy Owner Code List (VVL.099)\|	\|DE NO\| DATA ELEMENT NAME\|DEFINITION\| \|TPL058\|COVERAGE-TYPE \|Code indicating the level of coverage being provided under this policy for the insured by the TPL carrier.\|