COT.003.183

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

SERVICE-QUANTITY-ACTUAL

Data Element

DE Number

COT183

System DE Number

COT.003.183

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The quantity of a service or product that is rendered for a specific date of service or billing time span as reported by revenue code or procedure code on the claim line. For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMOT claims/encounter records, use the Service Quantity Actual field. This field is only applicable when the service being billed can be quantified in discrete units, e.g. a number of visits or the number of units of a prescription/refill that were filled.
Size	S9(8)V999
FLF Start Position	300
FLF Stop Position	310
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value may include up to 8 digits to the left of the decimal point, and 3 digits to the right e.g. 12345678.999 2. Conditional 3. If Type of Claim is in [1, 3, A, C, U, W], then this value must be reported. 4. When populated, corresponding Unit of Measure must be populated

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

RULE ID	RULE Definition
RULE-1653	If a claim is a non-denied claim from an OT file, then the claim service quantity actual value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(8)V999.

Measure ID	Measure Name
FFS-11-024-2	% of claim headers with SERVICE-QUANTITY-ACTUAL = 1
FFS-9-025-2	% of claim headers with SERVICE-QUANTITY-ACTUAL = 1
MCR-10-024-2	% of claim headers with SERVICE-QUANTITY-ACTUAL = 1
MCR-14-024-2	% of claim headers with SERVICE-QUANTITY-ACTUAL = 1
MIS-7-020-20	% missing: SERVICE-QUANTITY-ACTUAL (COT00003)
MIS-26-002-20	% missing: SERVICE-QUANTITY-ACTUAL (COT00003)
MIS-84-019-19	% missing: SERVICE-QUANTITY-ACTUAL (COT00003)

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

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/07/2023	3.12.0	COT.003.183	UPDATE	Definition	The quantity of a service or product that is rendered for a specific date of service or billing time span as reported by revenue code or procedure code on the claim line. For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMOT claims/encounter records, use the Service Quantity Actual field.	The quantity of a service or product that is rendered for a specific date of service or billing time span as reported by revenue code or procedure code on the claim line. For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMOT claims/encounter records, use the Service Quantity Actual field. This field is only applicable when the service being billed can be quantified in discrete units, e.g. a number of visits or the number of units of a prescription/refill that were filled.
06/24/2022	3.0.0	COT183	Rename DE	Data Dictionary - Record Layout	DE No\|Data Element Name COT183\|OT-RX-CLAIM-QUANTITY-ACTUAL	DE No\|Data Element Name COT183\|SERVICE-QUANTITY-ACTUAL
06/24/2022	3.0.0	COT183	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|DEFINITION\|CODING REQUIREMENT COT183\|OT-RX-CLAIM-QUANTITY-ACTUAL\|The quantity of a drug, service, or product that is rendered/dispensed for a prescription, specific date of service, or billing time span.\|For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMOT claims/encounter records, use the IP-LT-QUANTITY-OF-SERVICE field. The value in OT-RX-CLAIM-QUANTITY-ACTUAL must correspond with the value in UNIT-OF-MEASURE.This field is only applicable when the service being billed can be quantified in discrete units, e.g., a number of visits or the number of units of a prescription/refill that were filled. For prescriptions/refills, use the Medicaid Drug Rebate definition of a unit, which is the smallest unit by which the drug is normally measured; e.g. tablet, capsule, milliliter, etc. For drugs not identifiable or dispensed by a normal unit, e.g. powder filled vials, use 1 as the number of units	\|DE NO\| DATA ELEMENT NAME\|DEFINITION\|CODING REQUIREMENT COT183\|SERVICE-QUANTITY-ACTUAL\|The quantity of a service or product that is rendered for a specific date of service or billing time span as reported by revenue code or procedure code on the claim line.\| For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMOT claims/encounter records, use the SERVICE-QUANTITY-ACTUAL field.The value in SERVICE-QUANTITY-ACTUAL must correspond with the value in UNIT-OF-MEASURE.This field is only applicable when the service being billed can be quantified in discrete units, e.g., a number of visits or the number of units of a prescription/refill that were filled.
06/24/2022	3.0.0	COT183	Modify DE Width	Data Dictionary - Record Layout	SIZE S9(6)V999	SIZE S9(8)V999