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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

REFERRING-PROV-NPI-NUM-2

Data Element

DE Number

COT269

System DE Number

COT.003.269

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 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 line/detail of their claim.
Size X(10)
FLF Start Position 1190
FLF Stop Position 1199
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
DE Number System DE Number DE Name File Segment Number File Segment Name
COT251 COT.002.251 REFERRING-PROV-NPI-NUM-2 COT00002 CLAIM-HEADER-RECORD-OT