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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Tooth Surface DC049 December 1, 2010 - v2.1 Massachusetts
Tooth Surface DC049 June 7, 2013 - v3.1 Massachusetts
Tooth Surface DC049 October 1, 2014 - v4.0 Massachusetts
Data Element: Tooth Surface DC049 - December 1, 2010 - v2.1
(Massachusetts)
Tooth Surface DC049 - June 7, 2013 - v3.1
(Massachusetts)
Tooth Surface DC049 - October 1, 2014 - v4.0
(Massachusetts)
[Shared]Data Element ID DC049 DC049 DC049
[Shared]Definition Tooth Service Identification Tooth Service Identification Tooth Service Identification
[Shared] State / Source Massachusetts
Massachusetts
Massachusetts
[Unshared]Data Type Text External Code Source 10 - Text External Code Source 10 - Text
[Unshared]Data Type Description Line CDT External Code Source 10 - Tooth Surfaces External Code Source 10 - Tooth Surfaces
[Unshared]Format External Code Source 8 varchar[10] varchar[5]
[Unshared]Length 10 10 5
[Shared]Column 50 50 50
[Shared]Threshold 1 1 1
[Unshared]Encrypted No
[Unshared]Required Medicaid MCO Payers only
[Unshared]APCD - GIC Carrier Threshold 1 Not Supplied Not Supplied
[Unshared]Cat Not Supplied A2 A2
[Unshared]Condition Not Supplied Required when DC047 is populated Required when DC032=D2000-D2709
[Unshared]Date Active (version) '6/24/2010 Not Supplied Not Supplied
[Unshared]Element Submission Guideline Provides further detail on procedure. See lookup for valid values. This field is only required for MassHealth MCOs, MassHealth or Commonwealth Care Plans. Report the tooth surface(s) that this service relates to. Provides further detail on procedure. Report the tooth surface(s) that this service relates to. Provides further detail on procedure.
[Shared]File DC DC DC
[Unshared]Old Length 10 Not Supplied Not Supplied
Data Element: Tooth Surface DC049 - December 1, 2010 - v2.1
(Massachusetts)
Tooth Surface DC049 - June 7, 2013 - v3.1
(Massachusetts)
Tooth Surface DC049 - October 1, 2014 - v4.0
(Massachusetts)
There are no enumerated permissible values for these data elements.
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