COT.003.199

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TMSIS Dataguide

Medicaid.gov

Version 3.28.0

ORIGINATION-ADDR-LN1

Data Element

DE Number

COT199

System DE Number

COT.003.199

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 street address of the origination point from which a patient is transported either from home or Long term care facility to a health care provider for healthcare services or vice versa. For transportation claims, this is only required if state has captured this information, otherwise it is conditional.
Size	X(60)
FLF Start Position	397
FLF Stop Position	456
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 60 characters or less 2. Value must not be equal to associated Address Line 2 or Address Line 3 value(s) 3. Value must not contain a pipe or asterisk symbols 4. 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-1678	If the origination address line 1 is populated on a non-denied claim line from an OT file, then the origination address line 1 reported must not contain any pipe or asterisk characters.
RULE-6074	If a non-denied OT claim line origination address line 2 is populated, then origination address line 2 is not equal to origination address line1.
RULE-6609	If a claim line is a non-denied claim line from an OT file, then the origination address line 1 value reported must be compatible with specified T-MSIS picture format: X(60)

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
08/14/2023	3.12.0	COT.003.199	UPDATE	Coding requirement	1. Value must be 60 characters or less2. Value must not be equal to associated Address Line 2 (CE) or Address Line 3 (CE) value(s)3. Value must not contain a pipe or asterisk symbols4. Conditional	1. Value must be 60 characters or less2. Value must not be equal to associated Address Line 2 or Address Line 3 value(s)3. Value must not contain a pipe or asterisk symbols4. Conditional