TPL.004.058

COVERAGE-TYPE

Data Element

DE Number

TPL058

System DE Number

TPL.004.058

File Name

TPL - THIRD-PARTY LIABILITY

File Segment Number

TPL00004

File Segment Name

Last updated

09/12/2024

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Code indicating the level of coverage being provided under this policy for the insured by the TPL carrier.
Size	X(2)
FLF Start Position	56
FLF Stop Position	57
Segment Key Field Identifier	4
Coding Requirements	1. Value must be in Coverage Type List (VVL) 2. Value must be 2 characters 3. Mandatory

Search:

Show entries

Valid Value Code Set	Valid Value Code	Valid Value Name	Effective Start Date	Effective End Date
COVERAGE-TYPE	01	Drug	01/01/0001	12/31/9999
COVERAGE-TYPE	02	Professional (Physician) Visit - Office	01/01/0001	12/31/9999
COVERAGE-TYPE	03	Dental Care	01/01/0001	12/31/9999
COVERAGE-TYPE	04	Inpatient Hospital	01/01/0001	12/31/9999
COVERAGE-TYPE	05	Outpatient Hospital	01/01/0001	12/31/9999
COVERAGE-TYPE	06	Nursing Home	01/01/0001	12/31/9999
COVERAGE-TYPE	07	Vision	01/01/0001	12/31/9999
COVERAGE-TYPE	08	Durable Med Equip (rent)	01/01/0001	12/31/9999
COVERAGE-TYPE	09	Durable Med Equip (purchase)	01/01/0001	12/31/9999
COVERAGE-TYPE	10	Home Health	01/01/0001	12/31/9999
COVERAGE-TYPE	11	Mental health-outpatient	01/01/0001	12/31/9999
COVERAGE-TYPE	12	Mental health -inpatient	01/01/0001	12/31/9999
COVERAGE-TYPE	13	Psychiatric care- outpatient	01/01/0001	12/31/9999
COVERAGE-TYPE	14	Psychiatric care- inpatient	01/01/0001	12/31/9999
COVERAGE-TYPE	15	Rehabilitation	01/01/0001	12/31/9999
COVERAGE-TYPE	16	Cancer	01/01/0001	12/31/9999
COVERAGE-TYPE	17	Emergency Services	01/01/0001	12/31/9999
COVERAGE-TYPE	18	Chiropractic	01/01/0001	12/31/9999
COVERAGE-TYPE	19	Surgical	01/01/0001	12/31/9999
COVERAGE-TYPE	20	Diagnostic Medical, including X-ray and Lab Services	01/01/0001	12/31/9999
COVERAGE-TYPE	21	PT/OT/ST	01/01/0001	12/31/9999
COVERAGE-TYPE	22	Hospice	01/01/0001	12/31/9999
COVERAGE-TYPE	23	Transportation	01/01/0001	12/31/9999
COVERAGE-TYPE	98	Other	01/01/0001	12/31/9999

Search:

Show entries

RULE ID	RULE Definition
RULE-3123	If the coverage type is populated on a TPL medicaid eligible person health insurance coverage information file, then the coverage type reported must be found in the list of valid values.
RULE-6655	If a segment is a TPL medicaid eligible person health insurance coverage categories segment from a TPL file, the coverage type value reported must be compatible with the specified T-MSIS picture format: X(2).

Search:

Show entries

Measure ID	Measure Name
No data available in table

Search:

Show entries

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
TPL089	TPL.003.089	COVERAGE-TYPE	TPL00003	TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	TPL.004.058	UPDATE	Coding requirement	1. Value must be in Coverage Type List (VVL).2. Value must be 2 characters3. Mandatory	1. Value must be in Coverage Type List (VVL)2. Value must be 2 characters3. Mandatory
09/21/2023	3.13.0	TPL.004.058	UPDATE	Segment key field identifier	Not Applicable	4
06/24/2022	3.0.0	COVERAGE-TYPE	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME DEFINITION\| \|TPL058\|COVERAGE-TYPE\|This code identifies the relationship of the policy holder to the Medicaid/CHIP beneficiary. see Policy Owner Code List (VVL.099)\|	\|DE NO\| DATA ELEMENT NAME\|DEFINITION\| \|TPL058\|COVERAGE-TYPE \|Code indicating the level of coverage being provided under this policy for the insured by the TPL carrier.\|