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TMSIS Dataguide Medicaid.gov
Version 3.27.0

OTHER-TPL-COLLECTION

Data Element

DE Number

CLT217

System DE Number

CLT.003.217

File Segment Number

CLT00003

File Segment Name

CLAIM-LINE-RECORD-LT

Last updated

No Updates

Definition This data element indicates that the claim is for a beneficiary for whom other third party resource development and collection activities are in progress, when the liability is not another health insurance plan for which the eligible is a beneficiary.
Size X(3)
FLF Start Position 334
FLF Stop Position 336
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be in Other TPL Collection List (VVL)
2. Value must be 3 characters
3. Mandatory
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP122 CIP.002.122 OTHER-TPL-COLLECTION CIP00002 CLAIM-HEADER-RECORD-IP
CIP266 CIP.003.266 OTHER-TPL-COLLECTION CIP00003 CLAIM-LINE-RECORD-IP
CLT072 CLT.002.072 OTHER-TPL-COLLECTION CLT00002 CLAIM-HEADER-RECORD-LT
COT058 COT.002.058 OTHER-TPL-COLLECTION COT00002 CLAIM-HEADER-RECORD-OT
COT194 COT.003.194 OTHER-TPL-COLLECTION COT00003 CLAIM-LINE-RECORD-OT
CRX049 CRX.002.049 OTHER-TPL-COLLECTION CRX00002 CLAIM-HEADER-RECORD-RX
CRX137 CRX.003.137 OTHER-TPL-COLLECTION CRX00003 CLAIM-LINE-RECORD-RX