CLT.002.070

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

TOT-OTHER-INSURANCE-AMT

Data Element

DE Number

CLT070

System DE Number

CLT.002.070

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The amount paid by insurance other than Medicare or Medicaid on this claim.
Size	S9(11)V99
FLF Start Position	399
FLF Stop Position	411
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50) 3. Conditional

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

RULE ID	RULE Definition
RULE-987	If a claim is a non-denied claim from an LT file, then the total other insurance amount value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name
MIS-4-040-40	% missing: TOT-OTHER-INSURANCE-AMT (CLT00002)
MIS-23-045-45	% missing: TOT-OTHER-INSURANCE-AMT (CLT00002)
MIS-81-045-45	% missing: TOT-OTHER-INSURANCE-AMT (CLT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP119	CIP.002.119	TOT-OTHER-INSURANCE-AMT	CIP00002	CLAIM-HEADER-RECORD-IP
COT056	COT.002.056	TOT-OTHER-INSURANCE-AMT	COT00002	CLAIM-HEADER-RECORD-OT
CRX047	CRX.002.047	TOT-OTHER-INSURANCE-AMT	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.002.070	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. Conditional	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. Conditional