CLT.002.248

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide

Medicaid.gov

Version:

BILLING-PROV-ZIP-CODE

Data Element

DE Number

CLT248

System DE Number

CLT.002.248

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 ZIP code from X12 837I loop 2010AA.
Size	X(9)
FLF Start Position	1334
FLF Stop Position	1342
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value may only be 5 digits (0-9) (Example: 91320) or 9 digits (0-9) (Example: 913200011) 2. Value must be in ZIP Code List (VVL) 3. 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-8893	if a claim is a non-denied claim from a LT file, then the billing provider zip code value reported must be compatible with the specified T-MSIS picture format: X(9).
RULE-9178	if the CLAIM-HEADER-RECORD-LT segment is populated from a CLT file, then the BILLING-PROV-ZIP-CODE must be populated for non-denied claims.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP302	CIP.002.302	BILLING-PROV-ZIP-CODE	CIP00002	CLAIM-HEADER-RECORD-IP
COT240	COT.002.240	BILLING-PROV-ZIP-CODE	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CLT.002.248	UPDATE	File segment	None	30
09/16/2024	4.0.0	CLT.002.248	ADD	N/A		Created