CLT.002.028

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TMSIS Dataguide

Medicaid.gov

Version:

ADMITTING-DIAGNOSIS-CODE-FLAG

Data Element

DE Number

CLT028

System DE Number

CLT.002.028

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A flag that identifies the coding system used for the Admitting Diagnosis Code.
Size	X(1)
FLF Start Position	167
FLF Stop Position	167
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Diagnosis Code Flag List(VVL) 2. Value must be 1 character 3. 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-6147	If a claim is a non-denied claim from an LT file, then the admitting diagnosis code flag value reported must be compatible with specified T-MSIS picture format: X(1).
RULE-890	If the admitting diagnosis code is populated and the admitting diagnosis code flag is for ICD-9 or ICD-10 codes on a non-denied claim from an LT file, then the value for the admitting diagnosis code must be a valid value from the list of values for ICD-9 or ICD-10 codes, respectively.
RULE-891	If the admitting diagnosis code flag is populated on a non-denied claim from an LT file, then the admitting diagnosis code flag value reported must be in the list of valid values for admitting diagnosis code flag.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP031	CIP.002.031	ADMITTING-DIAGNOSIS-CODE-FLAG	CIP00002	CLAIM-HEADER-RECORD-IP

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/15/2023	3.12.0	CLT.002.028	UPDATE	Coding requirement	1. Value must be in Diagnosis Code Flag List(VVL)2. Value must be 1 character	1. Value must be in Diagnosis Code Flag List(VVL)2. Value must be 1 character3. Conditional