CLT.003.196

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

BEGINNING-DATE-OF-SERVICE

Data Element

DE Number

CLT196

System DE Number

CLT.003.196

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	For services received during a single encounter with a provider, the date the service covered by this claim was received. For services involving multiple encounters on different days, or periods of care extending over two or more days, this would be the date on which the service covered by this claim began. For capitation premium payments, the date on which the period of coverage related to this payment began. For financial transactions reported to the OT file, populate with the first day of the time period covered by this financial transaction.
Size	9(8)
FLF Start Position	167
FLF Stop Position	174
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 8 characters in the form "CCYYMMDD" 2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st) 3. When Type of Claim is not in [2,4,B,D,V] value must be less than or equal to associated End of Time Period value 4. Value must be less than or equal to associated Ending Date of Service value 5. When Type of Claim is not in [2,4,B,D,V] value must be less than or equal to associated Adjudication Date value 6. Value must be less than or equal to associated Date of Death (ELG.002.025) value when populated 7. Value must be less than or equal to at least one of the eligible's Enrollment End Date (ELG.021.254) values 8. Mandatory

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

RULE ID	RULE Definition
RULE-1216	If a claim line is a non-denied claim line from an LT file, then the beginning date of service value reported must be a valid date of the form CCYYMMDD.
RULE-1218	If beginning date of service and ending date of service are populated on a non-denied claim line from an LT file, then the beginning date of service value reported must be before or equal to the ending date of service value reported.
RULE-1219	If beginning date of service is populated on a non-denied claim line from an LT file that is not a capitated payment or premium payment and end of time period is populated on the file header, then the beginning date of service value reported must be before or equal to the end of time period value reported.
RULE-1220	If beginning date of service and adjudication date are populated on a non-denied claim line from an LT file that is not a capitated payment or premium payment, then the beginning date of service value reported must be before or equal to the adjudication date value reported.
RULE-1221	If a non-denied LT claim line has a value populated for beginning date of service and the date of death is populated on the primary demographics eligibility segment, then the line beginning date of service must be less than or equal to the date of death.
RULE-7252	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP FFS, Medicaid or Medicaid-expansion CHIP Encounter, separate CHIP FFS or separate CHIP Encounter claim, then the claim line beginning date of service must be populated.
RULE-7395	If a claim is a non-denied, non-void claim from an LT file, and is a Medicaid/Medicaid-expansion CHIP or S-CHIP service tracking claim and is an original claim or a replacement/resubmission claim payment then the claim line beginning date of service must be populated.
RULE-7710	If a claim is on a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP Encounter or separate CHIP Encounter claim, then the claim line beginning date of service must be populated.
RULE-7798	If a claim is on a non-denied claim and is an original claim or a replacement/resubmission claim payment from an LT file, and is a Medicaid or Medicaid-expansion CHIP Fee for Service or Separate CHIP Fee for Service claim, then the claim line beginning date of service must be populated.

Measure ID	Measure Name
ALL-21-006-6	% of SERVICING-PROV-NUM on claim lines that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service
MIS-5-002-20	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
MIS-58-001-1	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
RULE-1246	% of claim headers with a Servicing Provider Number that is not found on the provider file during the dates of service
MIS-24-003-3	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
MIS-82-002-2	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
RULE-7395	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
RULE-7444	% of claim lines that have a SERVICING-PROV-NUM does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service
MIS-5-002-2	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
RULE-7798	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)
RULE-7710	% missing: BEGINNING-DATE-OF-SERVICE (CLT00003)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP290	CIP.002.290	BEGINNING-DATE-OF-SERVICE	CIP00002	CLAIM-HEADER-RECORD-IP
CIP243	CIP.003.243	BEGINNING-DATE-OF-SERVICE	CIP00003	CLAIM-LINE-RECORD-IP
CLT048	CLT.002.048	BEGINNING-DATE-OF-SERVICE	CLT00002	CLAIM-HEADER-RECORD-LT
COT033	COT.002.033	BEGINNING-DATE-OF-SERVICE	COT00002	CLAIM-HEADER-RECORD-OT
COT166	COT.003.166	BEGINNING-DATE-OF-SERVICE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.003.196	UPDATE	Coding requirement	1. Value must be 8 characters in the form "CCYYMMDD"2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st)3. When Type of Claim is not in ['2', '4', 'B', 'D', 'V'] value must be less than or equal to associated End of Time Period value4. Value must be less than or equal to associated Ending Date of Service value5. When Type of Claim is not in ['2', '4', 'B', 'D', 'V'] value must be less than or equal to associated Adjudication Date value6. Value must be less than or equal to associated Date of Death (ELG.002.025) value when populated7. Value must be less than or equal to at least one of the eligible's Enrollment End Date (ELG.021.254) values8. Mandatory	1. Value must be 8 characters in the form "CCYYMMDD"2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st)3. When Type of Claim is not in [2,4,B,D,V] value must be less than or equal to associated End of Time Period value4. Value must be less than or equal to associated Ending Date of Service value5. When Type of Claim is not in [2,4,B,D,V] value must be less than or equal to associated Adjudication Date value6. Value must be less than or equal to associated Date of Death (ELG.002.025) value when populated7. Value must be less than or equal to at least one of the eligible's Enrollment End Date (ELG.021.254) values8. Mandatory