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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

DIAGNOSIS-RELATED-GROUP-IND

Data Element

DE Number

CIP069

System DE Number

CIP.002.069

File Name

CIP - CLAIM INPATIENT

File Segment Number

CIP00002

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition An indicator identifying the grouping algorithm used to assign Diagnosis Related Group (DRG) values.Values are generated by combining two types of information: Position 1-2, State/Group generating DRG: If state specific system, fill with two digit US postal code representation for state. If CMS Grouper, fill with 'HG'. If any other system, fill with 'XX'. Position 3-4, fill with the number that represents the DRG version used (01-98). For example, 'HG15' would represent CMS Grouper version 15. If version is unknown, fill with '99'.
Size X(4)
FLF Start Position 187
FLF Stop Position 190
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 4 characters or less
2. The right-most 2 positions must be found in [01-99]
3. Conditional
4. Value must be populated, when associated Diagnosis Related Group (CIP.002.068) is populated
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name