CRX.002.162

PRESCRIPTION-ORIGIN-CODE

Data Element

DE Number

CRX162

System DE Number

CRX.002.162

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00002

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	How the prescription was sent to the pharmacy.
Size	X(1)
FLF Start Position	1356
FLF Stop Position	1356
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be one digit 2. Value must be in Prescription Origin Code List (VVL) 3. Conditional

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

For background and context, see https://www.ncpdp.org/

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-7625	If a claim is a non-denied claim from an RX file, then the PRESCRIPTION-ORIGIN-CODE value reported must be compatible with the specified T-MSIS picture format: X(1).
RULE-7632	If the prescription origin code is populated on a non-denied claim from an RX file, then the prescription origin code value reported must be in the list of valid values for 'PRESCRIPTION-ORIGIN-CODE'.

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
02/27/2025	3.34.0	CRX.002.162	UPDATE	Coding requirement	1. Value must be one digit2. Value must be 1:43. Conditional	1. Value must be one digit2. Value must be in Prescription Origin Code List (VVL)3. Conditional
12/10/2024	3.33.0	CRX.002.162	UPDATE	Medicaid valid value info	See https://www.ncpdp.org/	For background and context, see https://www.ncpdp.org/
12/10/2024	3.33.0	CRX.002.162	UPDATE	Medicaid valid value info		See https://www.ncpdp.org/
06/24/2022	3.0.0	CRX162/ PRESCRIPTION-ORIGIN-CODE	ADD DE	Data Dictionary - Record Layout	N/A	DE_NO\|DATA_ELEMENT_NAME\|SIZE\|FILE NAME\|FILE SEGMENT CRX162\|PRESCRIPTION-ORIGIN-CODE\|X(1)\|CLAIMRX\|CLAIM-HEADER-RECORD-RX-CRX00002
06/24/2022	3.0.0	CRX162	ADD	Data Dictionary	N/A	\|DE NO\| DATA ELEMENT NAME\|NECESSITY \|DEFINITION\|CODING REQUIREMENT\|FILENAME\| FILE SEGMENT NAME CRX162\|PRESCRIPTION-ORIGIN-CODE\|Conditional\|How the prescription was sent to the pharmacy.\|Value must be one digit Value must be 1:4\|CLAIMRX\|CLAIM-HEADER-RECORD-RX-CRX00002
06/24/2022	3.0.0	CRX162	ADD	Data Dictionary - Valid Values	N/A	VALUE_SET_ID\|EFFECTIVE_DATE\|END_DATE\|VALUE\|DESCRIPTION\| PRESCRIPTION-ORIGIN-CODE\|20220624\|99991231\|1\|Written PRESCRIPTION-ORIGIN-CODE\|20220624\|99991231\|2\|Telephone PRESCRIPTION-ORIGIN-CODE\|20220624\|99991231\|3\|Electronic PRESCRIPTION-ORIGIN-CODE\|20220624\|99991231\|4\|Fax