COT.002.072

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

FORCED-CLAIM-IND

Data Element

DE Number

COT072

System DE Number

COT.002.072

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Indicates if the claim was processed by forcing it through a manual override process.
Size	X(1)
FLF Start Position	403
FLF Stop Position	403
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in [0, 1] or not populated 3. Value must be in Forced Claim Indicator List (VVL) 4. Conditional

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

RULE ID	RULE Definition
RULE-1431	If the forced claim indicator is populated on a non-denied claim from an OT file, then the forced claim indicator reported must be found in the list of valid values.
RULE-6759	If a claim is a non-denied claim from an OT file, then the forced claim indicator value reported must be compatible with specified T-MSIS picture format: X(1).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP138	CIP.002.138	FORCED-CLAIM-IND	CIP00002	CLAIM-HEADER-RECORD-IP
CLT090	CLT.002.090	FORCED-CLAIM-IND	CLT00002	CLAIM-HEADER-RECORD-LT
CRX061	CRX.002.061	FORCED-CLAIM-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/01/2023	3.11.0	COT.002.072	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Forced Claim Indicator List (VVL)4. Value must be 1 character5. Conditional	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Forced Claim Indicator List (VVL)4. Conditional