CLT.002.053

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TMSIS Dataguide

Medicaid.gov

Version:

TYPE-OF-BILL

Data Element

DE Number

CLT053

System DE Number

CLT.002.053

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 data element corresponding with UB-04 form locator FL4 that classifies the claim as to the type of facility (2nd digit), type of care (3rd digit) and the billing record's sequence in the episode of care (4th digit). (Note that the 1st digit is always zero.)
Size	X(4)
FLF Start Position	213
FLF Stop Position	216
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 4 characters 2. First character value must be a "0" 3. Second character value must be in Type of Bill 2 Facility Type List (VVL) 4. Third character value must be in Type of Bill 3 Classification Clinics List (VVL) 5. Fourth character value must be in Type of Bill 4 Frequency List (VVL) 6. 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-7005	If a claim is a non-denied claim from an LT file, then the type of bill value reported must be compatible with specified T-MSIS picture format: X(4).
RULE-952	If type of bill is populated on a non-denied claim from an LT file, then the type of bill value reported must be in the list of valid values for type of bill.

Measure ID	Measure Name
MIS-4-042-42	% missing: TYPE-OF-BILL (CLT00002)
FFS-52-006-6	% of claim headers where TYPE-OF-BILL does not begin with 02 (nursing facility) or 06 (ICF)
MCR-62-006-6	% of claim headers where TYPE-OF-BILL does not begin with 02 (nursing facility) or 06 (ICF)
ALL-32-001-1	Type of Bill values
MIS-23-047-47	% missing: TYPE-OF-BILL (CLT00002)
MIS-81-047-47	% missing: TYPE-OF-BILL (CLT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP101	CIP.002.101	TYPE-OF-BILL	CIP00002	CLAIM-HEADER-RECORD-IP
COT038	COT.002.038	TYPE-OF-BILL	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
12/19/2024	4.0.1	CLT.002.053	UPDATE	Coding requirement	1. Value must be 4 characters2. Value must be in Type of Bill List (VVL)3. First character must be a "0"4. Mandatory	1. Value must be 4 characters2. First character value must be a "0"3. Second character value must be in Type of Bill 2 Facility Type List (VVL)4. Third character value must be in Type of Bill 3 Classification Clinics List (VVL)5. Fourth character value must be in Type of Bill 4 Frequency List (VVL)6. Mandatory
09/16/2024	4.0.0	CLT.002.053	UPDATE	File segment	None	30
09/16/2024	4.0.0	CLT.002.053	ADD	N/A		Created