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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

REFERRING-PROV-NPI-NUM

Data Element

DE Number

CLT136

System DE Number

CLT.002.136

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

CLT00002

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The National Provider ID (NPI) of the provider who recommended the servicing provider to the patient.
Size X(10)
FLF Start Position 793
FLF Stop Position 802
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 10 digits
2. Value must have an associated Provider Identifier Type equal to "2"
3. Value must exist in the NPPES NPI data file
4. 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
CIP190 CIP.002.190 REFERRING-PROV-NPI-NUM CIP00002 CLAIM-HEADER-RECORD-IP
CIP319 CIP.003.319 REFERRING-PROV-NPI-NUM CIP00003 CLAIM-LINE-RECORD-IP
CLT265 CLT.003.265 REFERRING-PROV-NPI-NUM CLT00003 CLAIM-LINE-RECORD-LT
COT118 COT.002.118 REFERRING-PROV-NPI-NUM COT00002 CLAIM-HEADER-RECORD-OT
COT267 COT.003.267 REFERRING-PROV-NPI-NUM COT00003 CLAIM-LINE-RECORD-OT