COT.002.123

PLACE-OF-SERVICE

Data Element

DE Number

COT123

System DE Number

COT.002.123

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A data element corresponding with line 24b on the CMS-1500 that indicates where the services took place. This is a pass-through data element that should not be modified or derived when missing unless otherwise specified.
Size	X(2)
FLF Start Position	805
FLF Stop Position	806
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Place of Service Code List (VVL) 2. Value must be 2 characters 3. Conditional 4. If value is populated on a non-denied claim, then Procedure Code (COT.003.169) must be populated. 5. When Type of Service (COT.003.186) is in [119-122], Place of Service (COT.002.123) should not be populated

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

Place of Service Code List

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

RULE ID	RULE Definition
RULE-1559	If the place of service is populated on a non-denied claim from an OT file, then the place of service value reported must be in the list of valid values for place of service.
RULE-1560	If the type of service is for a a HMO, HIO, PACE, PCCM, or PHP capitation payment or for a premium payment on a non-denied claim line from an OT file, then the place of service value must not be populated.
RULE-7034	If a claim is a non-denied claim from an OT file, then the place of service value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-7351	If a non-denied claim from an OT file has the type of claim equal to '1','3','A','C', then the claim type of bill or place of service must be populated.
RULE-7746	If a non-denied claim from an OT file has the type of claim Medicaid or Medicaid-expansion CHIP Managed Care Encounter or Separate CHIP Encounter, then the claim type of bill or place of service must be populated.
RULE-7812	If a non-denied claim from an OT file has the type of claim Medicaid or Medicaid-expansion CHIP Managed Care Fee-for-service or Separate CHIP Fee-for-service, then the claim type of bill or place of service must be populated.

Measure ID	Measure Name
MCR-15-004-3	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
MCR-11-002-3	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
MCR-11-003-5	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
MCR-11-004-4	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
MCR-14-007-9	% of claim lines with ER Place of Service
MCR-14-008-19	% of claim lines with office Place of Service
MCR-14-009-18	% of claim lines with missing Place of Service
MCR-15-002-2	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
MCR-15-003-4	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
MCR-10-009-18	% of claim lines with missing Place of Service
MIS-6-025-25	% missing: PLACE-OF-SERVICE (COT00002)
MIS-25-026-26	% missing: PLACE-OF-SERVICE (COT00002)
MIS-83-026-26	% missing: PLACE-OF-SERVICE (COT00002)
ALL-13-004-4	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services
ALL-13-004-6	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related
RULE-7349	% of claim lines with non-missing Place of Service that have missing Procedure Code
RULE-7351	% of claim lines missing Type of Bill and Place of Service
FFS-12-003-2	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
ALL-15-002-2	% of claim lines with both Type of Bill and Place of Service non-missing
ALL-15-003-3	% of claim lines missing Type of Bill and Place of Service
FFS-10-002-3	% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
FFS-10-003-84	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
FFS-10-004-4	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
FFS-11-007-9	% of claim lines with ER Place of Service
FFS-11-008-19	% of claim lines with office Place of Service
FFS-11-009-18	% of claim lines with missing Place of Service
ALL-15-001-1	% of claim lines with non-missing Place of Service that have missing Procedure Code
FFS-12-004-4	% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
FFS-12-005-3	% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
FFS-9-007-9	% of claim lines with ER Place of Service
FFS-9-008-98	% of claim lines with office Place of Service
FFS-9-009-18	% of claim lines with missing Place of Service
MCR-10-007-9	% of claim lines with ER Place of Service
MCR-10-008-19	% of claim lines with office Place of Service

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/08/2023	3.12.0	COT123	ADD	Data Dictionary - Valid Values	N/A	VALUE_SET_ID\|EFFECTIVE_DATE\|END_DATE\|VALUE\|NAME\|DESCRIPTION PLACE-OF-SERVICE\|20231001\|99991231\|27\|Outreach Site/ Street\| A non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals.
04/17/2020	2.4.0	COT123	UPDATE	Data Dictionary	PLACE-OF-SERVICE (COT123): A code indicating where the service was performed. CMS 1500 values are used for this data element.	PLACE-OF-SERVICE (COT123): A data element corresponding with line 24b on the CMS-1500 that indicates where the services took place. This is a pass-through data element that should not be modified or derived when missing unless otherwise specified.
04/17/2020	2.4.0	COT123	UPDATE	Data Dictionary	Coding Requirement \| Leave field blank for capitation or premium payments (TYPE-OF-SERVICE = 119, 120, 121, 122)	PLACE-OF-SERVICE (COT123): “A data element corresponding with line 24b on the CMS-1500 that indicates where the services took place. This is a pass-through data element that should not be modified or derived when missing unless otherwise specified.”
05/13/2022	3.0.0	COT123	UPDATE	Data Dictionary - Valid Values	Replace VVL.178 - Place of Service Code List	https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set