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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

REFERRING-PROV-NUM-2

Data Element

DE Number

COT268

System DE Number

COT.003.268

File Name

COT - CLAIM OTHER

File Segment Number

COT00003

File Segment Name

CLAIM-LINE-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 1160
FLF Stop Position 1189
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 30 characters or less
2. Conditional
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
COT250 COT.002.250 REFERRING-PROV-NUM-2 COT00002 CLAIM-HEADER-RECORD-OT