MIS-17-001-1

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Measure Name	% missing: TYPE-OF-CLAIM (COT00002)
File Type	COT
Measure ID	MIS-17-001-1
Measure Type	Claims Percentage
Content area	MIS

Validation Type	Inferential

Measure Priority	N/A
Focus Area	N/A
Category	N/A

Claim Type	Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp
Adjustment Type	All Adjustment Types
Crossover Type	All Indicators

Minimum	0
Maximum	0.02
TA Minimun
TA Maximum
Longitudinal Threshold	N/A
For TA (for including in compliance training)	No
For TA (Longitudinal)	No

DD Data Element	TYPE-OF-CLAIM
DD Data Element Number	COT037

Annotation	N/A
Specification	N/A

Published Date	Data Guide Version	DQM	Action	Field	Before	After
11/20/2025	4.0.22	MIS-17-001-1	UPDATE	Annotation	Alphanumeric	N/A
11/20/2025	4.0.22	MIS-17-001-1	UPDATE	Specification	STEP 1: Active non-duplicate OT claims during DQ report monthDefine the OT claims universe at the header level that satisfy the following criteria:1. Reporting Period from the filename = DQ report month2. CLAIM-STATUS-CATEGORY is not equal to "F2" or is missing3. CLAIM-DENIED-INDICATOR is not equal to "0" or is missing4. TYPE-OF-CLAIM is not equal to "Z" or is missing5. CLAIM-STATUS is not equal to ("26","026","87","087","542","585", "654") or is missing6. No Header Duplicates: Duplicates are dropped at the header level, if the following four data elements are the same: ICN-ORIG, ICN-ADJ, ADJUDICATION-DATE, and ADJUSTMENT-IND.STEP 2: Missing data elementOf the claims that meet the criteria from STEP 2, select those whereFor alphanumeric data elements:1. [DATA-ELEMENT-NAME] does not contain any alpha character (A-Z or a-z) OR any digit 1-9For numeric data elements: 1. [DATA-ELEMENT-NAME] does not contain any digit 1-9STEP 3: Calculate percentageDivide the count of claims from STEP 2 by the count of claims from STEP 1	N/A
04/24/2025	4.0.7	MIS-17-001-1	ADD	N/A		Created

MIS-17-001-1

Key Information

Validation

Measure Priority

Claim Information

Thresholds

Data Elements