CLT.002.090

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

FORCED-CLAIM-IND

Data Element

DE Number

CLT090

System DE Number

CLT.002.090

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	Indicates if the claim was processed by forcing it through a manual override process.
Size	X(1)
FLF Start Position	481
FLF Stop Position	481
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in [0,1] or not populated 3. Value must be in Forced Claim Indicator List (VVL) 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-1017	If the forced claim indicator is populated on a non-denied claim from an LT file, then the forced claim indicator value reported must be in the list of valid values for 'forced claim ind'.
RULE-6189	If a claim is a non-denied claim from an LT file, then the forced claim indicator value reported must be compatible with specified T-MSIS picture format: X(1).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP138	CIP.002.138	FORCED-CLAIM-IND	CIP00002	CLAIM-HEADER-RECORD-IP
COT072	COT.002.072	FORCED-CLAIM-IND	COT00002	CLAIM-HEADER-RECORD-OT
CRX061	CRX.002.061	FORCED-CLAIM-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.002.090	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Forced Claim Indicator List (VVL)4. Conditional	1. Value must be 1 character2. Value must be in [0,1] or not populated3. Value must be in Forced Claim Indicator List (VVL)4. Conditional
08/01/2023	3.11.0	CLT.002.090	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Forced Claim Indicator List (VVL)4. Value must be 1 character5. Conditional	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Forced Claim Indicator List (VVL)4. Conditional