CLT.002.252

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TMSIS Dataguide

Medicaid.gov

Version:

SERVICE-FACILITY-LOCATION-CITY

Data Element

DE Number

CLT252

System DE Number

CLT.002.252

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 city name from X12 837I loop 2310E.
Size	X(28)
FLF Start Position	1473
FLF Stop Position	1500
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must not be more than 28 characters long 2. Conditional

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

RULE ID	RULE Definition
RULE-8897	if a claim is a non-denied claim from a LT file, then the service facility location city value reported must be compatible with the specified T-MSIS picture format: X(28).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP306	CIP.002.306	SERVICE-FACILITY-LOCATION-CITY	CIP00002	CLAIM-HEADER-RECORD-IP
COT244	COT.002.244	SERVICE-FACILITY-LOCATION-CITY	COT00002	CLAIM-HEADER-RECORD-OT
COT261	COT.003.261	SERVICE-FACILITY-LOCATION-CITY	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CLT.002.252	UPDATE	File segment	None	30
09/16/2024	4.0.0	CLT.002.252	ADD	N/A		Created