CIP.002.198

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TMSIS Dataguide

Medicaid.gov

Version 3.38.0

OUTLIER-DAYS

Data Element

DE Number

CIP198

System DE Number

CIP.002.198

File Name

CIP - CLAIM INPATIENT

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This field specifies the number of days paid as outliers under Prospective Payment System (PPS) and the days over the threshold for the DRG.
Size	S9(5)
FLF Start Position	1159
FLF Stop Position	1163
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be numeric 2. The value may be up to 5 digits in length 3. Value must be populated, if Outlier Code (CIP.002.197) equals "01" 4. 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-716	If a claim is a non-denied claim from an IP file, then the outlier days value reported must be compatible with specified T-MSIS picture format: S9(5).
RULE-717	If a non-denied IP claim has a value for outlier code equal to '1', then the outlier days must be populated.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CIP.002.198	UPDATE	Coding requirement	1. Value must be numeric2. The value may be up to 5 digits in length3. Value must be populated, if Outlier Code (CIP.002.197) equals '01.'4. Conditional	1. Value must be numeric2. The value may be up to 5 digits in length3. Value must be populated, if Outlier Code (CIP.002.197) equals "01"4. Conditional