COT.002.128

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

BORDER-STATE-IND

Data Element

DE Number

COT128

System DE Number

COT.002.128

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	A code to indicate whether an individual received services or equipment across state borders. (The provider location is out of state, but for payment purposes the provider is treated as an in-state provider.)
Size	X(1)
FLF Start Position	844
FLF Stop Position	844
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 Border State 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-1565	If the border state indicator is populated on a non-denied claim from an OT file, then the border state indicator reported must be found in the list of valid values.
RULE-7016	If a claim line is a non-denied claim line from an OT file, then the border state 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
CIP204	CIP.002.204	BORDER-STATE-IND	CIP00002	CLAIM-HEADER-RECORD-IP
CLT151	CLT.002.151	BORDER-STATE-IND	CLT00002	CLAIM-HEADER-RECORD-LT
CRX082	CRX.002.082	BORDER-STATE-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/01/2023	3.11.0	COT.002.128	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Border State 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 Border State Indicator List (VVL)4. Conditional