CLT.002.245

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TMSIS Dataguide

Medicaid.gov

Version:

BILLING-PROV-ADDR-LN-2

Data Element

DE Number

CLT245

System DE Number

CLT.002.245

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	Billing provider address line 2 from X12 837I loop 2010AA.
Size	X(60)
FLF Start Position	1244
FLF Stop Position	1303
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must not be more than 60 characters long 2. Conditional 3. Value must not be equal to associated Address Line 1 4. Value must not contain a pipe or asterisk symbols 5. There must be an Address Line 1 in order to have an Address Line 2

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-8890	if a claim is a non-denied claim from a LT file, then the billing provider address line 2 value reported must be compatible with the specified T-MSIS picture format: X(60).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP299	CIP.002.299	BILLING-PROV-ADDR-LN-2	CIP00002	CLAIM-HEADER-RECORD-IP
COT237	COT.002.237	BILLING-PROV-ADDR-LN-2	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CLT.002.245	UPDATE	File segment	None	30
09/16/2024	4.0.0	CLT.002.245	ADD	N/A		Created