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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

REMITTANCE-NUM

Data Element

DE Number

COT126

System DE Number

COT.002.126

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The Remittance Advice Number is a sequential number that identifies the current Remittance Advice (RA) produced for a provider. The number is incremented by one each time a new RA is generated. The RA is the detailed explanation of the reason for the payment amount.
Size X(30)
FLF Start Position 774
FLF Stop Position 803
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 30 characters or less
2. Value must not contain a pipe or asterisk symbols
3. Mandatory
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP202 CIP.002.202 REMITTANCE-NUM CIP00002 CLAIM-HEADER-RECORD-IP
CLT144 CLT.002.144 REMITTANCE-NUM CLT00002 CLAIM-HEADER-RECORD-LT
CRX081 CRX.002.081 REMITTANCE-NUM CRX00002 CLAIM-HEADER-RECORD-RX