CIP.002.203

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TMSIS Dataguide

Medicaid.gov

Version 3.38.0

SPLIT-CLAIM-IND

Data Element

DE Number

CIP203

System DE Number

CIP.002.203

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	An indicator that denotes that claims in excess of a pre-determined number of claim lines (threshold determined by the individual state) will be split during processing.
Size	X(1)
FLF Start Position	1196
FLF Stop Position	1196
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in [0,1] or not populated 3. Value must be in Split Claim Indicator List (VVL) 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-6374	If a claim is a non-denied claim from an IP file, then the split claim indicator value reported must be compatible with specified T-MSIS picture format: X(1).
RULE-723	If the split claim indicator is populated on a non-denied claim from an IP file, then the split claim indicator value reported must be in the list of valid values.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT150	CLT.002.150	SPLIT-CLAIM-IND	CLT00002	CLAIM-HEADER-RECORD-LT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CIP.002.203	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Split Claim Indicator List (VVL).4. Conditional	1. Value must be 1 character2. Value must be in [0,1] or not populated3. Value must be in Split Claim Indicator List (VVL)4. Conditional
09/21/2023	3.13.0	CIP.002.203	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Split Claim Indicator List (VVL).4. Value must be 1 character5. Conditional	1. Value must be 1 character2. Value must be in [0, 1] or not populated3. Value must be in Split Claim Indicator List (VVL).4. Conditional