08/28/2023 |
3.12.0 |
CLT.002.063 |
UPDATE |
Coding requirement |
1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Value must equal the sum of all Billed Amount instances for the associated claim4. Conditional5. Value should not be populated when associated Type of Claim is in [2, 4, 5, B, D E or X]6. Value should not be populated when associated Type of Claim (CIP.002.100) is equal to '4', 'D' or 'X'7. (individual line item payments) when populated and Payment Level Indicator (CLT.002.082) equals = '2' value must be greater than or equal to the sum of all claim line Revenue Charges (CLT.003.204) |
1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Value must equal the sum of all Billed Amount instances for the associated claim4. Conditional5. When associated Type of Claim in [‘1’, ’3’, ’A’, ’C’], value must be populated 6. Value should not be populated when associated Type of Claim (CLT.002.052) is equal to '4', 'D' or 'X'7. (individual line item payments) when populated and Payment Level Indicator (CLT.002.082) equals = '2' value must be greater than or equal to the sum of all claim line Revenue Charges (CLT.003.204) |
08/09/2023 |
3.11.0 |
CLT.002.063 |
UPDATE |
Definition |
The total amount billed for this claim at the claim header level as submitted by the provider. For encounter records, when Type of Claim value is [ 3, C, or W ], then value must equal amount the provider billed to the managed care plan. Total Billed Amount is not expected on financial
transactions. |
The total amount billed for this claim at the claim header level as submitted by the provider. For encounter records, when Type of Claim value is [ 3, C, or W ], then value must equal amount the provider billed to the managed care plan. Total Billed Amount is not expected on financial transactions.For sub-capitated encounters from a sub-capitated entity that is not a sub-capitated network provider, report the total amount that the provider billed the sub-capitated entity for the service. Report a null value in this field if the provider is a sub-capitated network provider.For sub-capitated encounters from a sub-capitated network provider, if the sub-capitated network provider directly employs the provider that renders the service to the enrollee, report a null value in this field. |
08/09/2023 |
3.11.0 |
CLT.002.063 |
UPDATE |
Last update date |
12/08/2022 |
8/9/2023 |
12/04/2020
|
2.4.0 |
TOT-BILLED-AMT
|
UPDATE |
Data Dictionary |
|DE NO| DATA ELEMENT NAME| DEFINITION| NECESSITY |CODING REQUIREMENT| |CIP112 |TOT-BILLED-AMT| Not Applicable |Not Applicable |If TYPE-OF-CLAIM = "4", then TOT-BILLED-AMT must = "00000000".| |CLT063 |TOT-BILLED-AMT| Not Applicable |Not Applicable |If TYPE-OF-CLAIM = "4", then TOT-BILLED-AMT must = "00000000".| |COT048 |TOT-BILLED-AMT| Not Applicable |Not Applicable |If TYPE-OF-CLAIM = "4", then TOT-BILLED-AMT must = "00000000".| |CRX039 |TOT-BILLED-AMT| Not Applicable |Not Applicable |If TYPE-OF-CLAIM = "4", then TOT-BILLED-AMT must = "00000000".| |
N/A |
06/11/2021
|
3.0.0 |
TOT-BILLED-AMT
|
UPDATE |
Data Dictionary |
"If associated Type of Claim value is 2, 4, 5, B, D, or E, then value should not be populated" |
N/A |
07/23/2021
|
3.0.0 |
TOT-BILLED-AMT (CIP.002.112)
|
UPDATE |
Data Dictionary |
“If associated Type of Claim value is 2, 4, 5, B, D, or E, then value should not be populated" |
N/A |
07/15/2022
|
3.0.1 |
CLT063
|
UPDATE |
Data Dictionary |
DE NO| DATA ELEMENT NAME COMPUTING|DEFINITION CLT063|TOT-BILLED-AMT|The total amount billed for this claim at the claim header level as submitted by the provider. For encounter records, when Type of Claim value is [ 3, C, or W ], then value must equal amount the provider billed to the managed care plan. Total Billed Amount is not expected on financial transactions. |
DE NO| DATA ELEMENT NAME COMPUTING|DEFINITION CLT063|TOT-BILLED-AMT|The total amount billed for this claim at the claim header level as submitted by the provider. For encounter records, when Type of Claim value is [ 3, C, or W ], then value must equal amount the provider billed to the managed care plan. Total Billed Amount is not expected on financial transactions.
For sub-capitated encounters from a sub-capitated entity that is not a sub-capitated network provider, report the total amount that the provider billed the sub-capitated entity for the service. Report a null value in this field if the provider is a sub-capitated network provider.
For sub-capitated encounters from a sub-capitated network provider, if the sub-capitated network provider directly employs the provider that renders the service to the enrollee, report a null value in this field. |