COT.002.231

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT

Data Element

DE Number

COT231

System DE Number

COT.002.231

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	The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance.
Size	S9(11)V99
FLF Start Position	1592
FLF Stop Position	1604
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 3. 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-7615	If a claim is a non-denied claim from an OT file, then the TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT value reported must be compatible with the specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP293	CIP.002.293	TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT	CIP00002	CLAIM-HEADER-RECORD-IP
CLT240	CLT.002.240	TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT	CLT00002	CLAIM-HEADER-RECORD-LT
CRX164	CRX.002.164	TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/10/2023	3.11.0	COT.002.231	UPDATE	Definition	The total coinsurance amount on a claim that the beneficiary is obligated to pay for covered services. This is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered service on the claim. Do not subtract out any payments made toward the copayment.	The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance.
08/10/2023	3.11.0	COT.002.231	UPDATE	Last update date	12/08/2022	8/10/2023
06/24/2022	3.0.0	COT231/ TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT	ADD DE	Data Dictionary - Record Layout	N/A	DE_NO\|DATA_ELEMENT_NAME\|SIZE\|FILE NAME\|FILE SEGMENT COT231\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|S9(11)V99\|CLAIMOT\|CLAIM-HEADER-RECORD-OT-COT00002
06/24/2022	3.0.0	COT231	ADD	Data Dictionary	N/A	\|DE NO\| DATA ELEMENT NAME\|NECESSITY \|DEFINITION\|CODING REQUIREMENT\|FILENAME\| FILE SEGMENT NAME COT231\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|Conditional\|The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance.\|Value must be between -99999999999.99 and 99999999999.99 Value must be expressed as a number with 2-digit precision (e.g. 100.50 )\|CLAIMOT\|CLAIM-HEADER-RECORD-OT-COT00002
10/07/2022	3.0.3	CIP293, CLT240, COT231, CRX164	UPDATE	Data Dictionary	DE NO\| DATA ELEMENT NAME COMPUTING\|DEFINITION\| CIP293\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total copayment amount on a claim that the beneficiary is obligated to pay for covered services. This is the total Medicaid or contract negotiated beneficiary copayment liability for covered service on the claim. Do not subtract out any payments made toward the copayment. CLT240\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total copayment amount on a claim that the beneficiary is obligated to pay for covered services. This is the total Medicaid or contract negotiated beneficiary copayment liability for covered service on the claim. Do not subtract out any payments made toward the copayment. COT231\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total copayment amount on a claim that the beneficiary is obligated to pay for covered services. This is the total Medicaid or contract negotiated beneficiary copayment liability for covered service on the claim. Do not subtract out any payments made toward the copayment. CRX164\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total copayment amount on a claim that the beneficiary is obligated to pay for covered services. This is the total Medicaid or contract negotiated beneficiary copayment liability for covered service on the claim. Do not subtract out any payments made toward the copayment.	DE NO\| DATA ELEMENT NAME COMPUTING\|DEFINITION\| CIP293\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance. CLT240\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance. COT231\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance. CRX164\|TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT\|The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance.