TPL.003.034

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TMSIS Dataguide

Medicaid.gov

Version 3.36.0

INSURANCE-PLAN-ID

Data Element

DE Number

TPL034

System DE Number

TPL.003.034

File Name

TPL - THIRD-PARTY LIABILITY

File Segment Number

File Segment Name

TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The ID number issued by the Insurance carrier providing third party liability insurance coverage to beneficiaries. Typically the Plan ID/Plan Number is on the beneficiaries' insurance card.
Size	X(20)
FLF Start Position	54
FLF Stop Position	73
Segment Key Field Identifier	4
Coding Requirements	1. Value must be 20 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

RULE ID	RULE Definition
RULE-3088	If the insurance plan id is populated on a non-denied claim from an IP file, then the insurance plan id reported must not contain any pipe or asterisk characters.
RULE-6736	If a segment is a TPL medicaid eligible person health insurance coverage information segment from a TPL file, the insurance plan identification value reported must be compatible with the specified T-MSIS picture format: X(20).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
TPL056	TPL.004.056	INSURANCE-PLAN-ID	TPL00004	TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/21/2023	3.13.0	TPL.003.034	UPDATE	Segment key field identifier	Not Applicable	4