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TMSIS Dataguide Medicaid.gov

Version:

SERVICE-FACILITY-LOCATION-STATE

Data Element

DE Number

CIP307

System DE Number

CIP.002.307

File Segment Number

CIP00002

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Definition Service facility location address state code from X12 837I loop 2310E.
Size X(2)
FLF Start Position 1687
FLF Stop Position 1688
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must not be more than 2 characters
2. Value must be in State Code list (VVL)
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
CLT253 CLT.002.253 SERVICE-FACILITY-LOCATION-STATE CLT00002 CLAIM-HEADER-RECORD-LT
COT245 COT.002.245 SERVICE-FACILITY-LOCATION-STATE COT00002 CLAIM-HEADER-RECORD-OT
COT262 COT.003.262 SERVICE-FACILITY-LOCATION-STATE COT00003 CLAIM-LINE-RECORD-OT