CLT.002.151

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

BORDER-STATE-IND

Data Element

DE Number

CLT151

System DE Number

CLT.002.151

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 whether an individual received services or equipment across state borders. (The provider location is out of state, but for payment purposes the provider is treated as an in-state provider.)
Size	X(1)
FLF Start Position	951
FLF Stop Position	951
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 Border State 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-1157	If the border state indicator is populated on a non-denied claim from an LT file, then the border state indicator reported must be found in the list of valid values.
RULE-6715	If a claim is a non-denied claim from an LT file, then the border state 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
CIP204	CIP.002.204	BORDER-STATE-IND	CIP00002	CLAIM-HEADER-RECORD-IP
COT128	COT.002.128	BORDER-STATE-IND	COT00002	CLAIM-HEADER-RECORD-OT
CRX082	CRX.002.082	BORDER-STATE-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/01/2023	3.11.0	CLT.002.151	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Border State 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 Border State Indicator List (VVL)4. Conditional