CLT.002.246

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TMSIS Dataguide

Medicaid.gov

Version:

BILLING-PROV-CITY

Data Element

DE Number

CLT246

System DE Number

CLT.002.246

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 city name from X12 837I loop 2010AA.
Size	X(28)
FLF Start Position	1304
FLF Stop Position	1331
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must not be more than 28 characters long 2. 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-8891	if a claim is a non-denied claim from a LT file, then the billing provider city value reported must be compatible with the specified T-MSIS picture format: X(28).
RULE-9176	if the CLAIM-HEADER-RECORD-LT segment is populated from a CLT file, then the BILLING-PROV-CITY must be populated for non-denied claims.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP300	CIP.002.300	BILLING-PROV-CITY	CIP00002	CLAIM-HEADER-RECORD-IP
COT238	COT.002.238	BILLING-PROV-CITY	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CLT.002.246	UPDATE	File segment	None	30
09/16/2024	4.0.0	CLT.002.246	ADD	N/A		Created