CLT.003.202

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

REVENUE-CENTER-QUANTITY-ACTUAL

Data Element

DE Number

CLT202

System DE Number

CLT.003.202

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	On facility claim entries, this field is to capture the actual service quantity by revenue code category, e.g., number of days in a particular type of accommodation, pints of blood, etc. However, when HCPCS codes are required for services, the units are equal to the number of times the procedure/service being reported was performed. For CLAIMOT claims/encounter records use Service Quantity Actual and CLAIMRX claims/encounter records use the Prescription Quantity Actual field.
Size	S9(6)V999
FLF Start Position	189
FLF Stop Position	197
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be numeric 2. Value may include up to 6 digits to the left of the decimal point, and 3 digits to the right e.g. 123456.789 3. 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-1230	If a claim is a non-denied claim from an LT file, then the revenue center quantity actual value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(6)V999.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP249	CIP.003.249	REVENUE-CENTER-QUANTITY-ACTUAL	CIP00003	CLAIM-LINE-RECORD-IP

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CLT.003.202	UPDATE	Definition	On facility claim entries, this field is to capture the actual service quantity by revenue code category, e.g., number of days in a particular type of accommodation, pints of blood, etc. However, when HCPCS codes are required for services, the units are equal to the number of times the procedure/service being reported was performed. For CLAIMOT claims/encounter records use Service Quantity Actual and CLAIMRX claims/encounter records use the Prescription Quantity Actual field	On facility claim entries, this field is to capture the actual service quantity by revenue code category, e.g., number of days in a particular type of accommodation, pints of blood, etc. However, when HCPCS codes are required for services, the units are equal to the number of times the procedure/service being reported was performed. For CLAIMOT claims/encounter records use Service Quantity Actual and CLAIMRX claims/encounter records use the Prescription Quantity Actual field.
06/24/2022	3.0.0	CLT202/ REVENUE-CENTER-QUANTITY-ACTUAL	Rename DE	Data Dictionary - Record Layout	DE No\|Data Element Name CLT202\|IP-LT-QUANTITY-OF-SERVICE-ACTUAL	DE No\|Data Element Name CLT202\|REVENUE-CENTER-QUANTITY-ACTUAL
06/24/2022	3.0.0	CLT202	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|CODING REQUIREMENT CLT202\|IP-LT-QUANTITY-OF-SERVICE-ACTUAL\|For use with CLAIMIP and CLAIMLT claims. For CLAIMOT and CLAIMRX claims/encounter records, use the OT-RX-CLAIM-QUANTITY-ACTUAL field	\|DE NO\| DATA ELEMENT NAME\|CODING REQUIREMENT CLT202\|REVENUE-CENTER-QUANTITY-ACTUAL\|For use with CLAIMIP and CLAIMLT claims. For CLAIMOT claims/encounter records use SERVICE-QUANTITY-ACTUAL and CLAIMRX claims/encounter records use the PRESCRIPTION-QUANTITY-ACTUAL field