CRX.002.073

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TMSIS Dataguide

Medicaid.gov

Version:

BILLING-PROV-SPECIALTY

Data Element

DE Number

CRX073

System DE Number

CRX.002.073

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This code describes the area of specialty for the provider being reported.
Size	X(2)
FLF Start Position	529
FLF Stop Position	530
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Provider Specialty List (VVL) 2. Value must be 2 characters 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-1850	If the billing provider specialty is populated on a non-denied claim from an RX file, then the billing provider specialty reported must be found in the list of valid values.
RULE-7061	If a claim line is a non-denied claim line from an RX file, then the billing provider specialty value reported must be compatible with specified T-MSIS picture format: X(2).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP183	CIP.002.183	BILLING-PROV-SPECIALTY	CIP00002	CLAIM-HEADER-RECORD-IP
CLT134	CLT.002.134	BILLING-PROV-SPECIALTY	CLT00002	CLAIM-HEADER-RECORD-LT
COT116	COT.002.116	BILLING-PROV-SPECIALTY	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CRX.002.073	UPDATE	Coding requirement	1. Value must be in Provider Specialty List (VVL).2. Value must be 2 characters3. Conditional	1. Value must be in Provider Specialty List (VVL)2. Value must be 2 characters3. Conditional