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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

OTHER-INSURANCE-AMT

Data Element

DE Number

COT213

System DE Number

COT.003.213

File Name

COT - CLAIM OTHER

File Segment Number

COT00003

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The amount paid by insurance other than Medicare or Medicaid on this claim.
Size S9(11)V99
FLF Start Position 728
FLF Stop Position 740
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be between -99999999999.99 and 99999999999.99
2. Value must be expressed as a number with 2-digit precision (e.g. 100.50)
3. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP272 CIP.003.272 OTHER-INSURANCE-AMT CIP00003 CLAIM-LINE-RECORD-IP
CLT207 CLT.003.207 OTHER-INSURANCE-AMT CLT00003 CLAIM-LINE-RECORD-LT
CRX152 CRX.003.152 OTHER-INSURANCE-AMT CRX00003 CLAIM-LINE-RECORD-RX