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TMSIS Dataguide Medicaid.gov
Version 3.27.0

TYPE-OF-SERVICE

Data Element

DE Number

CIP257

System DE Number

CIP.003.257

File Segment Number

CIP00003

File Segment Name

CLAIM-LINE-RECORD-IP

Last updated

Definition

A code to categorize the services provided to a Medicaid or CHIP enrollee.

Size X(3)
FLF Start Position 261
FLF Stop Position 263
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value must be 3 characters
2. Mandatory
3. Value must not equal '086' if Sex (ELG.002.023) equals 'M'
4. Value must be in ['001', '058', '060', '084', '086', '090', '091', '092', '093', '123', '132', '135', '136', '137']

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
CLT211 CLT.003.211 TYPE-OF-SERVICE CLT00003 CLAIM-LINE-RECORD-LT
COT186 COT.003.186 TYPE-OF-SERVICE COT00003 CLAIM-LINE-RECORD-OT
CRX134 CRX.003.134 TYPE-OF-SERVICE CRX00003 CLAIM-LINE-RECORD-RX