COT.002.251

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TMSIS Dataguide

Medicaid.gov

Version:

REFERRING-PROV-NPI-NUM-2

Data Element

DE Number

COT251

System DE Number

COT.002.251

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	The National Provider ID (NPI) of the provider who recommended the servicing provider to the patient. This is only applicable when a provider reports a second referral at the header of their claim.
Size	X(10)
FLF Start Position	1484
FLF Stop Position	1493
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 10 digits 2. Conditional 3. Value must have an associated Provider Identifier Type equal to "2" 4. Value must exist in the NPPES NPI File 5. Value must not be populated when Referring Provider NPI Number is not populated 6. Value must not equal Referring Provider NPI Number

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

RULE ID	RULE Definition
RULE-8982	if a claim is a non-denied claim from an OT file, then the referring provider number 2 value reported must be compatible with the specified T-MSIS picture format: X(10).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
COT269	COT.003.269	REFERRING-PROV-NPI-NUM-2	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	COT.002.251	UPDATE	File segment	None	35
09/16/2024	4.0.0	COT.002.251	ADD	N/A		Created