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TMSIS Dataguide Medicaid.gov
Version 3.27.0

TOOTH-NUM

Data Element

DE Number

COT196

System DE Number

COT.003.196

File Name

COT - CLAIM OTHER

File Segment Number

COT00003

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The tooth number serviced based on the tooth numbering system identified in the TOOTH-DESIGNATION-SYSTEM field.
Size X(2)
FLF Start Position 392
FLF Stop Position 393
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be in Tooth Number List (VVL)
2. If Tooth Designation System (COT.003.195) is 'JP' value must be found in [1..32][51-82][A..T]or [AS..KS]
3. If Tooth Designation System (COT.003.195) is 'JO' value must have 1 digit before and after the decimal (N.N)
4. If Tooth Designation System (COT.003.195) is 'JO' value must be a first digit of 1-4 and the decimal must be between 1-8
5. Value must be 2 characters or less
6. Conditional
7. When value is in ['A'-'T'], the difference between Ending Date of Service (COT.002.034) and Date of Birth (COT.002.108) is less than 15 years
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name