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Data Element
CLT129
CLT.002.129
Definition | Field specifying the waiver or demonstration which authorized payment for a claim. These IDs must be the approved, full federal waiver ID number assigned during the state submission and CMS approval process. Waiver IDs should actually only be the "core" part of the waiver IDs, without including suffixes for renewals or amendments. |
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Size | X(20) |
FLF Start Position | 755 |
FLF Stop Position | 774 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be associated with a populated Waiver Type |
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 |
---|---|---|---|---|
CIP178 | CIP.002.178 | WAIVER-ID | CIP00002 | CLAIM-HEADER-RECORD-IP |
COT111 | COT.002.111 | WAIVER-ID | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX069 | CRX.002.069 | WAIVER-ID | CRX00002 | CLAIM-HEADER-RECORD-RX |
ELG172 | ELG.012.172 | WAIVER-ID | ELG00012 | WAIVER-PARTICIPATION |
MCR068 | MCR.005.068 | WAIVER-ID | MCR00005 | MANAGED-CARE-OPERATING-AUTHORITY |