CLT.003.197

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TMSIS Dataguide

Medicaid.gov

Version:

ENDING-DATE-OF-SERVICE

Data Element

DE Number

CLT197

System DE Number

CLT.003.197

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	For services received during a single encounter with a provider, the date the service covered by this claim was received. For services involving multiple encounters on different days, or periods of care extending over two or more days, the date on which the service covered by this claim ended.
Size	9(8)
FLF Start Position	175
FLF Stop Position	182
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. The date must be a valid calendar date in the form "CCYYMMDD" 2. Value must be less than or equal to associated End of Time Period value 3. Value must be greater than or equal to associated Beginning Date of Service value 4. Value must be less than or equal to associated Adjudication Date value 5. Value must be less than or equal to associated Date of Death (ELG.002.025) value when populated 6. Value must be equal to or greater than associated Date of Birth (ELG.002.024) value 7. 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-1218	If beginning date of service and ending date of service are populated on a non-denied claim line from an LT file, then the beginning date of service value reported must be before or equal to the ending date of service value reported.
RULE-1222	If a claim line is a non-denied claim line from an LT file, then the ending date of service value reported must be a valid date of the form CCYYMMDD.
RULE-1225	If ending date of service and adjudication date are populated on a non-denied claim line from an LT file that is not a capitated payment or premium payment, then the ending date of service value reported must be before or equal to the adjudication date value reported.
RULE-1226	If a non-denied LT claim line has a value populated for ending date of service and the date of death is populated on the primary demographics eligibility segment, then the line ending date of service must be less than or equal to the date of death.
RULE-1227	If ending date of service is populated on a non-denied claim line from an LT file that is not a capitated payment or premium payment and end of time period is populated on the file header, then the ending date of service value reported must be before or equal to the end of time period value reported.
RULE-7253	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP FFS, Medicaid or Medicaid-expansion CHIP Encounter, separate CHIP FFS or separate CHIP Encounter claim, then the claim line ending date of service must be populated.
RULE-7399	If a claim is a non-denied claim, non-void claim from an LT file, and is a Medicaid/Medicaid-expansion CHIP or S-CHIP service tracking claim and is an original claim or a replacement/resubmission claim payment then the claim line ending date of service must be populated.
RULE-7711	If a claim is on a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP Encounter or separate CHIP Encounter claim, then the claim line ending date of service must be populated.
RULE-7797	If a claim is on a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP Fee for Service or Separate CHIP Fee for Service claim, then the claim line ending date of service must be populated.

Measure ID	Measure Name
MIS-5-004-4	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
MIS-58-002-2	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
RULE-1246	% of claim headers with a Servicing Provider Number that is not found on the provider file during the dates of service
MIS-24-004-4	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
MIS-82-003-3	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
RULE-7399	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
RULE-7797	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
RULE-7711	% missing: ENDING-DATE-OF-SERVICE (CLT00003)
RULE-7926	% of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service
RULE-7934	% of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP291	CIP.002.291	ENDING-DATE-OF-SERVICE	CIP00002	CLAIM-HEADER-RECORD-IP
CIP244	CIP.003.244	ENDING-DATE-OF-SERVICE	CIP00003	CLAIM-LINE-RECORD-IP
CLT049	CLT.002.049	ENDING-DATE-OF-SERVICE	CLT00002	CLAIM-HEADER-RECORD-LT
COT034	COT.002.034	ENDING-DATE-OF-SERVICE	COT00002	CLAIM-HEADER-RECORD-OT
COT167	COT.003.167	ENDING-DATE-OF-SERVICE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CLT.003.197	UPDATE	File segment	None	31
09/16/2024	4.0.0	CLT.003.197	ADD	N/A		Created