TRICARE Systems Manual 7950.3-M, April 1, 2015 Chapter 2 TRICARE Encounter Data (TED) Revision: C-16, June 22, 2018 Section/Addendum Subject/Addendum Title 1.1 Data Reporting - TRICARE Encounter Data (TED) Record Submission 1.2 Data Reporting - Provider File Record Submission 2.1 Data Requirements - Overview 2.2 Data Requirements - Data Element Layout 2.3 Data Requirements - Header Record Data 2.4 Data Requirements - Institutional/Non-Institutional Record Data Elements (A - D) 2.5 Data Requirements - Institutional/Non-Institutional Record Data Elements (E - L) 2.6 Data Requirements - Institutional/Non-Institutional Record Data Elements (M - O) 2.7 Data Requirements - Institutional/Non-Institutional Record Data Elements (P) 2.8 Data Requirements - Institutional/Non-Institutional Record Data Elements (Q - S) 2.9 Data Requirements - Institutional/Non-Institutional Record Data Elements (T - Z) 2.10 Data Requirements - Provider Record Data 3.1 General Edit Requirements - Overview 4.1 Header Edit Requirements (ELN 000 - 099) 5.1 Institutional Edit Requirements (ELN 000 - 099) 5.2 Institutional Edit Requirements (ELN 100 - 199) 5.3 Institutional Edit Requirements (ELN 200 - 299) 5.4 Institutional Edit Requirements (ELN 300 - 399) 5.5 Institutional Edit Requirements (ELN 400 - 499) 6.1 Non-Institutional Edit Requirements (ELN 000 - 099) 6.2 Non-Institutional Edit Requirements (ELN 100 - 199) 6.3 Non-Institutional Edit Requirements (ELN 200 - 299) 6.4 Non-Institutional Edit Requirements (ELN 300 - 399) 7.1 Provider Edit Requirements (ELN 000 - 099) 7.2 Provider Edit Requirements (ELN 100 - 199) 8.1 Financial Edit Requirements A Data Requirements - Country And/Or Islands Codes B Data Requirements - State Codes Figure 2.B-1 State Codes Figure 2.B-2 Medicare State Codes C Data Requirements - Provider’s Major Specialty Codes Figure 2.C-1 Provider Major Specialty Codes For Use On Non-Institutional TED Records For Outpatient Hospital Care D Data Requirements - Type Of Institution Codes Figure 2.D-1 Type Of Institution E Data Requirements - Other Special Procedure Codes Figure 2.E-1 Outpatient Procedure Codes Figure 2.E-2 Defense Health Agency (DHA)-Approved Procedure Codes For Retail And Mail Order Pharmacy (MOP) Only F Data Requirements - Place Of Service/Type Of Service Allowable Relationships Figure 2.F-1 Place Of Service Codes Figure 2.F-2 Place Of Service Values Figure 2.F-3 Type Of Service Second Position Values G Data Requirements - Adjustment/Denial Reason Codes Figure 2.G-1 Denial Codes Figure 2.G-2 Denial/Adjustment Codes Figure 2.G-3 Adjustment/Remark Codes H Data Requirements - Revenue Codes I Data Requirements - Contract Area Of Responsibility Figure 2.I-1 Contract Areas Of Responsibility Awarded Before January 2018 J Data Requirements - Pay Plan Code Valid Values K Data Requirements - Dependent Elements And Values For Rank Code, Sponsor Pay Category L Data Requirements - Health Care Delivery Program (HCDP) Plan Coverage Code Values M Data Requirements - Default Values For Complete Claims Denials Figure 2.M-1 Common Elements Figure 2.M-2 Institutional-Specific Elements Figure 2.M-3 Non-Institutional-Specific elements N UB-04/UB-92 Conversion Table - To Be Used For Reporting Non-Institutional TRICARE Encounter Data (TED) Records