CLT.003.221

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TMSIS Dataguide

Medicaid.gov

Version 3.28.0

PROV-FACILITY-TYPE

Data Element

DE Number

CLT221

System DE Number

CLT.003.221

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	The type of facility in which services on the claim were rendered. The Provider Facility Type code set is based on corresponding groups of HIPAA provider taxonomy codes.
Size	X(9)
FLF Start Position	342
FLF Stop Position	350
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Provider Facility Type List (VVL) 2. Value must be 9 characters or less 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-1258	If the provider facility type is populated on a non-denied claim line LT file, then the value reported must be in the list of valid values for provider facility type
RULE-7087	If a claim is a non-denied claim from an LT file line from an LT file, then the provider facility type value reported must be compatible with specified T-MSIS picture format: X(9).

Measure ID	Measure Name
MIS-5-012-12	% missing: PROV-FACILITY-TYPE (CLT00003)
MIS-24-011-11	% missing: PROV-FACILITY-TYPE (CLT00003)
MIS-82-010-10	% missing: PROV-FACILITY-TYPE (CLT00003)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP267	CIP.003.267	PROV-FACILITY-TYPE	CIP00003	CLAIM-LINE-RECORD-IP

Published Date	Data Guide Version	Data Element	Action	Field	Before	After