COT.002.137

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TMSIS Dataguide

Medicaid.gov

Version:

COPAY-WAIVED-IND

Data Element

DE Number

COT137

System DE Number

COT.002.137

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	An indicator signifying that the copay was waived by the provider
Size	X(1)
FLF Start Position	876
FLF Stop Position	876
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in Copay Waived Indicator List (VVL) 3. Situational

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

RULE ID	RULE Definition
RULE-1577	If the copay waiver indicator is populated on a non-denied claim from an OT file, then the copay waiver indicator reported must be found in the list of valid values.
RULE-6236	If a claim is a non-denied claim from an OT file, then the copay waived indicator value reported must be compatible with specified T-MSIS picture format: X(1).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP213	CIP.002.213	COPAY-WAIVED-IND	CIP00002	CLAIM-HEADER-RECORD-IP
CLT160	CLT.002.160	COPAY-WAIVED-IND	CLT00002	CLAIM-HEADER-RECORD-LT
CRX095	CRX.002.095	COPAY-WAIVED-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	COT.002.137	UPDATE	File segment	None	35
09/16/2024	4.0.0	COT.002.137	ADD	N/A		Created