CLT.002.163

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

THIRD-PARTY-COINSURANCE-AMOUNT-PAID

Data Element

DE Number

CLT163

System DE Number

CLT.002.163

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	The amount of money paid by a third party on behalf of the beneficiary towards coinsurance.
Size	S9(11)V99
FLF Start Position	1067
FLF Stop Position	1079
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 3. Situational

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

RULE ID	RULE Definition
RULE-1171	If a claim is a non-denied claim from an LT file, then the third party coinsurance amount paid value reported must be compatible with specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP216	CIP.002.216	THIRD-PARTY-COINSURANCE-AMOUNT-PAID	CIP00002	CLAIM-HEADER-RECORD-IP
COT140	COT.002.140	THIRD-PARTY-COINSURANCE-AMOUNT-PAID	COT00002	CLAIM-HEADER-RECORD-OT
CRX098	CRX.002.098	THIRD-PARTY-COINSURANCE-AMOUNT-PAID	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/29/2023	3.12.0	CLT.002.163	UPDATE	Necessity	Optional	Situational
08/23/2023	3.12.0	CLT.002.163	UPDATE	Coding requirement	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Optional	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Situational