CLT.002.251

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TMSIS Dataguide

Medicaid.gov

Version:

SERVICE-FACILITY-LOCATION-ADDR-LN-2

Data Element

DE Number

CLT251

System DE Number

CLT.002.251

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	Service facility location address line 2 from X12 837I loop 2310E.
Size	X(60)
FLF Start Position	1413
FLF Stop Position	1472
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. There must be an Address Line 1 in order to have an Address Line 2 5. Value must not contain a pipe or asterisk symbols

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

RULE ID	RULE Definition
RULE-8896	if a claim is a non-denied claim from a LT file, then the service facility location 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
CIP305	CIP.002.305	SERVICE-FACILITY-LOCATION-ADDR-LN-2	CIP00002	CLAIM-HEADER-RECORD-IP
COT243	COT.002.243	SERVICE-FACILITY-LOCATION-ADDR-LN-2	COT00002	CLAIM-HEADER-RECORD-OT
COT260	COT.003.260	SERVICE-FACILITY-LOCATION-ADDR-LN-2	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CLT.002.251	UPDATE	File segment	None	30
09/16/2024	4.0.0	CLT.002.251	ADD	N/A		Created