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TMSIS Dataguide Medicaid.gov
Version 3.27.0

CLT - CLAIM LONG-TERM CARE

File

File Segments Reference

The table below lists the File Segments included in the File:

File Segment Number File Segment Name File Segment Definition
CLT00001 FILE-HEADER-RECORD-LT A record containing metadata necessary to identify the file itself, when it was created and the number of records it contains.
CLT00002 CLAIM-HEADER-RECORD-LT A record to capture data about a long-term care claim or encounter that applies to the claim in its totality.
CLT00003 CLAIM-LINE-RECORD-LT A record to capture data about specific goods or services rendered to a Medicaid/CHIP enrollee during a long-term care stay.
Definition
Institutional long-term care facility claims and managed care encounter records.

Overview

Diagram 2: Claim LT File – Claim Record Segment Relationships

clt_overview

Description of Diagram 2:

Each claim record in the T-MSIS long-term care claims file is composed of two types of record segments: One claim header segment and multiple claim line segments. Each claim line segment joins to its claim header segment on the following four data elements:

1. SUBMITTING-STATE
2. ICN-ORIG
3. ICN-ADJ
4. ADJUDICATION-DATE
5. ADJUSTMENT-IND (LINE-ADJUSTMENT-IND)