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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

REMITTANCE-NUM

Data Element

DE Number

CLT144

System DE Number

CLT.002.144

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 Remittance Advice Number is a sequential number that identifies the current Remittance Advice (RA) produced for a provider. The number is incremented by one each time a new RA is generated. The RA is the detailed explanation of the reason for the payment amount.
Size X(30)
FLF Start Position 817
FLF Stop Position 846
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 30 characters or less
2. Value must not contain a pipe or asterisk symbols
3. Mandatory
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
CIP202 CIP.002.202 REMITTANCE-NUM CIP00002 CLAIM-HEADER-RECORD-IP
COT126 COT.002.126 REMITTANCE-NUM COT00002 CLAIM-HEADER-RECORD-OT
CRX081 CRX.002.081 REMITTANCE-NUM CRX00002 CLAIM-HEADER-RECORD-RX