CLT.002.083

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

MEDICARE-REIM-TYPE

Data Element

DE Number

CLT083

System DE Number

CLT.002.083

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	A code to indicate the type of Medicare reimbursement.
Size	X(2)
FLF Start Position	452
FLF Stop Position	453
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Medicare Reimbursement Type List (VVL) 2. Value is mandatory and must be provided, when Crossover Indicator is equal to "1" (Crossover Claim) 3. Value must be 2 characters 4. 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-1009	If the medicare reim type is populated on a non-denied claim from an LT file, then the medicare reim type value reported must be in the list of valid values for 'medicare reim type'.
RULE-6351	If a non-denied LT claim, the medicare reim type value must be specified in the T-MSIS picture format: X(2).

Measure ID	Measure Name
MIS-4-027-27	% missing: MEDICARE-REIM-TYPE (CLT00002)
MIS-23-029-29	% missing: MEDICARE-REIM-TYPE (CLT00002)
MIS-81-029-29	% missing: MEDICARE-REIM-TYPE (CLT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP133	CIP.002.133	MEDICARE-REIM-TYPE	CIP00002	CLAIM-HEADER-RECORD-IP
COT069	COT.002.069	MEDICARE-REIM-TYPE	COT00002	CLAIM-HEADER-RECORD-OT
CRX059	CRX.002.059	MEDICARE-REIM-TYPE	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.002.083	UPDATE	Coding requirement	1. Value must be in Medicare Reimbursement Type List (VVL)2. Value is mandatory and must be provided, when Crossover Indicator is equal to '1' (Crossover Claim)3. Value must be 2 characters4. Conditional	1. Value must be in Medicare Reimbursement Type List (VVL)2. Value is mandatory and must be provided, when Crossover Indicator is equal to "1" (Crossover Claim)3. Value must be 2 characters4. Conditional