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Data Element
CLT128
CLT.002.128
Definition | A code for specifying waiver type under which the eligible individual is covered during the month and receiving services/under which claim is submitted. |
---|---|
Size | X(2) |
FLF Start Position | 753 |
FLF Stop Position | 754 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be in Waiver Type List (VVL) 2. Value must be 2 characters 3. Value must match Eligible Waiver Type (ELG.012.173) for the enrollee for the same time period (by date of service) 4. Value must have a corresponding value in Waiver ID (CLT.002.129) 5. Conditional |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
---|---|---|---|---|
CIP177 | CIP.002.177 | WAIVER-TYPE | CIP00002 | CLAIM-HEADER-RECORD-IP |
COT110 | COT.002.110 | WAIVER-TYPE | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX068 | CRX.002.068 | WAIVER-TYPE | CRX00002 | CLAIM-HEADER-RECORD-RX |
ELG173 | ELG.012.173 | WAIVER-TYPE | ELG00012 | WAIVER-PARTICIPATION |