COT.003.259

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TMSIS Dataguide

Medicaid.gov

Version:

SERVICE-FACILITY-LOCATION-ADDR-LN-1

Data Element

DE Number

COT259

System DE Number

COT.003.259

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Service facility location address line 1 from X12 837P loop 2420C and 837D loop 2420D.
Size	X(60)
FLF Start Position	946
FLF Stop Position	1005
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must not be more than 60 characters long 2. Conditional 3. Value must not contain a pipe or asterisk symbols

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

RULE ID	RULE Definition
RULE-8990	if a claim is a non-denied claim from an OT file, then the service facility location address line 1 value reported must be compatible with the specified T-MSIS picture format: X(60).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP304	CIP.002.304	SERVICE-FACILITY-LOCATION-ADDR-LN-1	CIP00002	CLAIM-HEADER-RECORD-IP
CLT250	CLT.002.250	SERVICE-FACILITY-LOCATION-ADDR-LN-1	CLT00002	CLAIM-HEADER-RECORD-LT
COT242	COT.002.242	SERVICE-FACILITY-LOCATION-ADDR-LN-1	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	COT.003.259	UPDATE	File segment	None	36
09/16/2024	4.0.0	COT.003.259	ADD	N/A		Created