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TMSIS Dataguide Medicaid.gov
Version 3.27.0

PRE-AUTHORIZATION-NUM

Data Element

DE Number

COT223

System DE Number

COT.003.223

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 A number, code or other value that indicates the services provided on this claim have been authorized by the payee or other service organization, or that a referral for services has been approved. (Also referred to as a Prior Authorization or Referral Number).
Size X(18)
FLF Start Position 1270
FLF Stop Position 1287
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 18 characters or less
2. Value must not contain a pipe or asterisk symbols
3. Conditional
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
CIP288 CIP.003.288 PRE-AUTHORIZATION-NUM CIP00003 CLAIM-LINE-RECORD-IP
CLT235 CLT.003.235 PRE-AUTHORIZATION-NUM CLT00003 CLAIM-LINE-RECORD-LT
CRX159 CRX.003.159 PRE-AUTHORIZATION-NUM CRX00003 CLAIM-LINE-RECORD-RX