COT.002.137

COPAY-WAIVED-IND

Data Element

DE Number

COT137

System DE Number

COT.002.137

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

09/12/2024

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	An indicator signifying that the copay was discounted or waived by the provider (e.g., physician or hospital). Do not use to indicate administrative-level, Medicaid State Agency or Medicaid MCO copayment waived decisions.
Size	X(1)
FLF Start Position	909
FLF Stop Position	909
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Copayment Waived Indicator List (VVL) 2. Value must be 1 character 3. Value must be in [0,1] 4. Situational

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Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date
COPAY-WAIVED-IND	0	Not Waived: The provider did not waive the beneficiary's copayment,		01/01/0001	12/31/9999
COPAY-WAIVED-IND	1	Waived: The provider waived the beneficiary's copayment.		01/01/0001	12/31/9999

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RULE ID	RULE Definition
RULE-1577	If the copay waiver indicator is populated on a non-denied claim from an OT file, then the copay waiver indicator reported must be found in the list of valid values.
RULE-6236	If a claim is a non-denied claim from an OT file, then the copay waived indicator value reported must be compatible with specified T-MSIS picture format: X(1).

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Measure ID	Measure Name
No data available in table

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DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP213	CIP.002.213	COPAY-WAIVED-IND	CIP00002	CLAIM-HEADER-RECORD-IP
CLT160	CLT.002.160	COPAY-WAIVED-IND	CLT00002	CLAIM-HEADER-RECORD-LT
CRX095	CRX.002.095	COPAY-WAIVED-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	COT.002.137	UPDATE	Coding requirement	1. Value must be in Copayment Waived Indicator List (VVL)2. Value must be 1 character3. Value must be in [0, 1]4. Situational	1. Value must be in Copayment Waived Indicator List (VVL)2. Value must be 1 character3. Value must be in [0,1]4. Situational
08/28/2023	3.12.0	COT.002.137	UPDATE	Definition	Not Applicable	An indicator signifying that the copay was discounted or waived by the provider (e.g., physician or hospital). Do not use to indicate administrative-level, Medicaid State Agency or Medicaid MCO copayment waived decisions.
08/28/2023	3.12.0	COT.002.137	UPDATE	Necessity	Not Applicable	Situational
08/28/2023	3.12.0	COT.002.137	UPDATE	Coding requirement	Optional	1. Value must be in Copayment Waived Indicator List (VVL)2. Value must be 1 character3. Value must be in [0, 1]4. Situational
06/24/2022	3.0.0	COT137	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|DEFINITION COT137\|COPAY-WAIVED-IND\|An indicator signifying that the copay was waived by the provider.	\|DE NO\| DATA ELEMENT NAME\|DEFINITION COT137\|COPAY-WAIVED-IND\|An indicator signifying that the copay was discounted or waived by the provider (e.g., physician or hospital). Do not use to indicate administrative-level, Medicaid State Agency or Medicaid MCO copayment waived decisions.