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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

REFERRING-PROV-NUM-2

Data Element

DE Number

COT250

System DE Number

COT.002.250

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 A unique identification number assigned to a provider which identifies the physician or other provider who referred the patient. For physicians, this must be the individual's ID number, not a group identification number. If the referring provider number is not available, but the physician's Drug Enforcement Agency (DEA) ID is on the State file, then the State should use the DEA ID for this data element. This is only applicable when a provider reports a second referral at the header of their claim.
Size X(30)
FLF Start Position 1454
FLF Stop Position 1483
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 30 characters or less
2. Conditional
3. Value must not be populated when Referring Provider Number is not populated.
4. Value must not equal Referring Provider Number
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
COT268 COT.003.268 REFERRING-PROV-NUM-2 COT00003 CLAIM-LINE-RECORD-OT