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Data Element
CLT219
CLT.003.219
Definition | A code to indicate the Federal funding source for the payment. |
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Size | X(2) |
FLF Start Position | 335 |
FLF Stop Position | 336 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be 2 characters 2. Value must be in Category for Federal Reimbursement List (VVL) 3. (Federal Funding under Title XXI) if value equals "02", then the eligible's CHIP Code (ELG.003.054) must be in [2,3] 4. (Federal Funding under Title XIX) if value equals "01" then the eligible's CHIP Code (ELG.003.054) must be "1" 5. Conditional 6. If Type of Claim is in [1,A,U] and the Total Medicaid Paid Amount is populated on the corresponding claim header, then value must be reported |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CIP269 | CIP.003.269 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | CIP00003 | CLAIM-LINE-RECORD-IP |
COT210 | COT.003.210 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | COT00003 | CLAIM-LINE-RECORD-OT |
CRX149 | CRX.003.149 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | CRX00003 | CLAIM-LINE-RECORD-RX |
FTX045 | FTX.002.045 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00002 | INDIVIDUAL-CAPITATION-PMPM |
FTX090 | FTX.003.090 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00003 | INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT |
FTX134 | FTX.004.134 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00004 | GROUP-INSURANCE-PREMIUM-PAYMENT |
FTX176 | FTX.005.176 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00005 | COST-SHARING-OFFSET |
FTX218 | FTX.006.218 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00006 | VALUE-BASED-PAYMENT |
FTX263 | FTX.007.263 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00007 | STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM |
FTX303 | FTX.008.303 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00008 | COST-SETTLEMENT-PAYMENT |
FTX342 | FTX.009.342 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00009 | FQHC-WRAP-PAYMENT |
FTX390 | FTX.095.390 | CATEGORY-FOR-FEDERAL-REIMBURSEMENT | FTX00095 | MISCELLANEOUS-PAYMENT |