CLT.003.201

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

IMMUNIZATION-TYPE

Data Element

DE Number

CLT201

System DE Number

CLT.003.201

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-LT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	[No longer essential - Both data element and associated requirement(s); preserved for file submission integrity. See Data Dictionary v2.3 for specific definition and coding requirement description(s).]
Size	X(2)
FLF Start Position	187
FLF Stop Position	188
Segment Key Field Identifier	Not Applicable
Coding Requirements	Not Applicable

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

RULE ID	RULE Definition
RULE-1229	If the immunization type is populated on a non-denied claim from an LT file, then the immunization type value reported must be in the list of valid values.
RULE-6173	If a claim line is a non-denied claim line from an LT file, then the immunization type value reported must be compatible with specified T-MSIS picture format: X(2).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP248	CIP.003.248	IMMUNIZATION-TYPE	CIP00003	CLAIM-LINE-RECORD-IP
COT173	COT.003.173	IMMUNIZATION-TYPE	COT00003	CLAIM-LINE-RECORD-OT
CRX147	CRX.003.147	IMMUNIZATION-TYPE	CRX00003	CLAIM-LINE-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After