CLT.002.095

OCCURRENCE-CODE-04

Data Element

DE Number

CLT095

System DE Number

CLT.002.095

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	A code to describe specific event(s) relating to this billing period covered by the claim. (These are From Locators 31, 32, 33, 34, 35, and 36 - Occurrence Codes on the UB04.) These fields can be used for either occurrences or occurrence spans.
Size	X(2)
FLF Start Position	489
FLF Stop Position	490
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Occurrence Code List (VVL) 2. Value must be 2 characters 3. Conditional

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

Occurrence Codes

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

RULE ID	RULE Definition
RULE-1022	If the occurrence code 04 is populated on a non-denied claim from an LT file, then the occurrence code 04 value reported must be in the list of valid values for 'occurrence code'.
RULE-6794	If a claim line is a non-denied claim line from an LT file, then the occurrence code 04 value reported must be compatible with specified T-MSIS picture format: X(2).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP143	CIP.002.143	OCCURRENCE-CODE-04	CIP00002	CLAIM-HEADER-RECORD-IP
COT077	COT.002.077	OCCURRENCE-CODE-04	COT00002	CLAIM-HEADER-RECORD-OT