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TMSIS Dataguide Medicaid.gov
Version 3.27.0

TOOTH-QUAD-CODE

Data Element

DE Number

COT197

System DE Number

COT.003.197

File Name

COT - CLAIM OTHER

File Segment Number

COT00003

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

No Updates

Definition The area of the oral cavity is designated by a two-digit code.
Size X(2)
FLF Start Position 394
FLF Stop Position 395
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be in Tooth Quad Code List (VVL)
2. Value must be 2 characters
3. Conditional
4. When populated, associated type of service value must be in [013, 029, 035]
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