CLT.002.048

BEGINNING-DATE-OF-SERVICE

Data Element

DE Number

CLT048

System DE Number

CLT.002.048

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

CLT00002

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	For services received during a single encounter with a provider, the date the service covered by this claim was received. For services involving multiple encounters on different days, or periods of care extending over two or more days, this would be the date on which the service covered by this claim began. For capitation premium payments, the date on which the period of coverage related to this payment began. For financial transactions reported to the OT file, populate with the first day of the time period covered by this financial transaction.
Size	9(8)
FLF Start Position	233
FLF Stop Position	240
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 8 characters in the form "CCYYMMDD" 2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st) 3. When Type of Claim is not in ['2', '4', 'B', 'D', 'V'] value must be less than or equal to associated End of Time Period value 4. Value must be less than or equal to associated Ending Date of Service value 5. When Type of Claim is not in ['2', '4', 'B', 'D', 'V'] value must be less than or equal to associated Adjudication Date value 6. Value must be less than or equal to associated Date of Death (ELG.002.025) value when populated 7. Value must be less than or equal to at least one of the eligible's Enrollment End Date (ELG.021.254) values 8. Mandatory

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

RULE ID	RULE Definition
RULE-7712	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP Encounter or separate CHIP Encounter claim, then the claim header beginning date of service must be populated.
RULE-7982	If a claim in a non-denied, original or adjustment FFS crossover claim from an LT file, and the MSIS ID is populated and the beginning date of service is populated with a date that overlaps with the reported eligibility determinant effective and end dates, and the primary eligibility group indicator is equal to '1', then the dual eligible code is equal to '01', '02', '04', '08'
RULE-7743	If a claim in a non-denied, original or adjustment Encounter crossover claim from an LT file, and the MSIS ID is populated and the beginning date of service is populated with a date that overlaps with the reported eligibility determinant effective and end dates, and the primary eligibility group indicator is equal to '1', then the dual eligible code is equal to '01', '02', '04', '08'
RULE-7800	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP Fee for Service or Separate CHIP Fee for Service claim, then the claim header beginning date of service must be populated.
RULE-937	If a claim is a non-denied claim from an LT file and the date of death is populated on the primary demographic eligibilty segment and the beginning date of service is populated in the claim header, then beginning date of service is less than or equal to the date of death.
RULE-936	If beginning date of service and adjudication date are populated on a non-denied claim from an LT file that is not a Medicaid or Medicaid-expansion, S-CHIP, or Other Capitated Payment, then the beginning date of service value reported must be before or equal to the adjudication date value reported.
RULE-935	If the beginning date of service and ending date of service are populated on a non-denied claim from an LT file, then the beginning date of service value reported must be before or equal to the ending date of service value reported.
RULE-934	If beginning date of service is populated on a non-denied claim from an LT file that is not a Medicaid or Medicaid-expansion, S-CHIP, or other Capitated Payment and end of time period is populated on the file header, then the beginning date of service value reported must be before or equal to the end of time period value reported.
RULE-932	If a claim is a non-denied claim from an LT file, then the beginning date of service value reported must be a valid date of the form CCYYMMDD.
RULE-7771	If a claim is a non-denied claim from an LT file, and the waiver type is populated, and the claim beginning date of service is between the waiver enrollment effective and end dates, then the claim waiver type is equal to the waiver participation waiver type.
RULE-1011	If a non-denied LT claim has a value populated for non covered days, medicaid covered inpatient days and a value populated for beginning date of service and ending date of service, then the sum of the covered days of service is less than or equal to the number of days between the claim beginning and end dates of service, plus one day.
RULE-7551	If the 1115A demonstration indicator is equal to 1 (yes) on a non-denied claim from an LT file, and the beginning date of service is within the 1115A effective and end dates, then the 1115A demonstration indicator value reported on the 1115A demonstration information segment must be populated with a 1 value.
RULE-7413	If a claim in a non-denied, original or adjustment FFS or Encounter crossover claim from an LT file, and the MSIS ID is populated and the beginning date of service is populated with a date that overlaps with the reported eligibility determinant effective and end dates, and the primary eligibility group indicator is equal to '1', then the dual eligible code is equal to '01','02', '04', '08'
RULE-7394	If a claim is a non-denied, non-void claim from an LT file, and is a Medicaid/Medicaid-expansion CHIP or S-CHIP service tracking claim and is an original claim or a replacement/resubmission claim payment, then the claim header ending date of service must be populated.
RULE-7212	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP FFS, Medicaid or Medicaid-expansion CHIP Encounter, separate CHIP FFS or separate CHIP Encounter claim, then the claim header beginning date of service must be populated.
RULE-7199	If plan ID is populated on a non-denied Medicaid, S-CHIP, or Other encounter from an LT file, then the plan ID must be equal to the plan ID on a managed care main segment from an MCR file where the beginning date of service on the claim is within the contract effective and end dates of the managed care main segment.
RULE-7195	If plan ID is populated on a non-denied Medicaid, S-CHIP, or Other encounter from an LT file, then the plan ID must be equal to the plan ID on a managed care participation segment from an ELG file with the same MSIS ID and effective and end dates that overlap the beginning date of service.
RULE-1155	If beginning date of service and ending date of service are populated on a non-denied LT claim, then the nursing facility days value must be less than or equal to the days between the beginning date of service and ending date of service plus one day.
RULE-1150	If beginning date of service and ending date of service are populated on a non-denied LT claim, then the ICF-IID days value must be less than or equal to the days between the beginning date of service and ending date of service plus one day.

Measure ID	Measure Name
RULE-884	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
RULE-7712	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
RULE-7800	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
RULE-7199	% of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period
RULE-7195	% of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period
RULE-7440	% of claim headers with a BILLING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service
RULE-7643	% of claim headers with an MSIS ID not enrolled on Beginning Date of Service
RULE-7394	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
MIS-81-003-3	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
MIS-23-003-3	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
ALL-14-002-2	% of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Beginning Date of Service
RULE-1126	% of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service
MIS-57-001-1	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
MIS-4-003-3	% missing: BEGINNING-DATE-OF-SERVICE (CLT00002)
MCR-31-007-7	% of MSIS IDs enrolled on Beginning Date of Service
MCR-31-002-2	% of MSIS IDs enrolled on Beginning Date of Service
FFS-25-006-6	% of MSIS IDs enrolled on Beginning Date of Service
FFS-25-002-2	% of MSIS IDs enrolled on Beginning Date of Service
ALL-21-002-2	% of BILLING-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service
ALL-14-006-6	% of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Beginning Date of Service

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP290	CIP.002.290	BEGINNING-DATE-OF-SERVICE	CIP00002	CLAIM-HEADER-RECORD-IP
CIP243	CIP.003.243	BEGINNING-DATE-OF-SERVICE	CIP00003	CLAIM-LINE-RECORD-IP
CLT196	CLT.003.196	BEGINNING-DATE-OF-SERVICE	CLT00003	CLAIM-LINE-RECORD-LT
COT033	COT.002.033	BEGINNING-DATE-OF-SERVICE	COT00002	CLAIM-HEADER-RECORD-OT
COT166	COT.003.166	BEGINNING-DATE-OF-SERVICE	COT00003	CLAIM-LINE-RECORD-OT