CLT.002.133

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TMSIS Dataguide

Medicaid.gov

Version:

BILLING-PROV-TYPE

Data Element

DE Number

CLT133

System DE Number

CLT.002.133

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to describe the type of provider being reported.
Size	X(2)
FLF Start Position	827
FLF Stop Position	828
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Provider Type Code List (VVL) 2. Value must be 2 characters 3. 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-1131	If the billing provider type is populated on a non-denied claim from an LT file, then the billing provider type reported must be found in the list of valid values.
RULE-6865	The format for BILLING-PROV-TYPE on a non-denied LT claim was expected to be submitted as X(2).

Measure ID	Measure Name
MIS-4-009-9	% missing: BILLING-PROV-TYPE (CLT00002)
MIS-23-010-10	% missing: BILLING-PROV-TYPE (CLT00002)
MIS-81-010-10	% missing: BILLING-PROV-TYPE (CLT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP182	CIP.002.182	BILLING-PROV-TYPE	CIP00002	CLAIM-HEADER-RECORD-IP
COT115	COT.002.115	BILLING-PROV-TYPE	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.002.133	UPDATE	Coding requirement	1. Value must be in Provider Type Code List (VVL).2. Value must be 2 characters3. Conditional	1. Value must be in Provider Type Code List (VVL)2. Value must be 2 characters3. Conditional