COT.003.198

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

TOOTH-SURFACE-CODE

Data Element

DE Number

COT198

System DE Number

COT.003.198

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to identify the tooth's surface on which the service was performed.
Size	X(1)
FLF Start Position	396
FLF Stop Position	396
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Tooth Surface Code List (VVL) 2. Value must be 1 character 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

RULE ID	RULE Definition
RULE-1677	If the tooth surface code is populated on a non-denied, non-void claim line from an OT file, then the tooth surface code must be a valid value from the list of tooth surface code values.
RULE-6623	If a claim line is a non-denied claim line from an OT file, then the tooth surface code value reported must be compatible with specified T-MSIS picture format: X(1)

Measure ID	Measure Name

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

Published Date	Data Guide Version	Data Element	Action	Field	Before	After