CIP.002.094

ADMISSION-DATE

Data Element

DE Number

CIP094

System DE Number

CIP.002.094

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	The date on which the recipient was admitted to a hospital.
Size	9(8)
FLF Start Position	299
FLF Stop Position	306
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. The date must be a valid calendar date in the form "CCYYMMDD" 2. Value must be less than or equal to associated Discharge Date value in the claim header 3. Value must be greater than or equal to associated eligible Date of Birth value 4. Value must be less than or equal to associated eligible Date of Death value 5. Mandatory 6. Value must be between Enrollment Effective Date (ELG.021.253) and Enrollment End Date (ELG.021.254) 7. Value must be before Adjudication Date (CIP.003.286)

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

RULE ID	RULE Definition
RULE-7382	If a claim is a non-denied, non-void claim from an IP file, and is a Medicaid/Medicaid-expansion CHIP or S-CHIP service tracking claim and is an original claim or a replacement/resubmission claim payment then the claim admission date must be populated.
RULE-841	If admission date is populated on a non-denied claim from an IP file that is not a Medicaid or Medicaid-expansion, S-CHIP, or Other Capitated Payment and adjudication date is populated on a non-denied claim line that is not a capitated payment or premium payment, then the admission date value reported must be before or equal to the adjudication date value reported.
RULE-7981	If a claim in a non-denied, original or adjustment FFS crossover claim from an IP file, and the MSIS ID is populated and the admission date is populated with a date that overlaps with the reported eligibility determinant effective and end dates, and the primary eligibility group indicator is equal to '1', then the dual eligible code is equal to '01', '02', '04', '08'
RULE-7806	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an IP file, and is a Medicaid or Medicaid-expansion CHIP Fee for Service or Separate CHIP Fee for Service claim, then the claim header admission date value must be populated.
RULE-7770	If a claim is a non-denied claim from an IP file, and the waiver type is populated, and the claim admission date is between the waiver enrollment effective and end dates, then the claim waiver type is equal to the waiver participation waiver type.
RULE-7744	If a claim in a non-denied, original or adjustment Encounter crossover claimfrom an IP file, and the MSIS ID is populated and the admission date is populated with a date that overlaps with the reported eligibility determinant effective and end dates, and the primary eligibility group indicator is equal to '1', then the dual eligible code is equal to '01','02', '04', '08'
RULE-7715	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an IP file, and is a Medicaid or Medicaid-expansion CHIP Encounter, or separate CHIP Encounter claim, then the claim header admission date value must be populated.
RULE-7550	If the 1115A demonstration indicator is equal to 1 (yes) on a non-denied claim from an IP file, and the admission date is within the 1115A effective and end dates, then the 1115A demonstration indicator value reported on the 1115A demonstration information segment must be populated with a 1 value.
RULE-7412	If a claim in a non-denied, original or adjustment FFS or Encounter crossover claim from an IP file, and the MSIS ID is populated and the admission date is populated with a date that overlaps with the reported eligibility determinant effective and end dates, and the primary eligibility group indicator is equal to '1', then the dual eligible code is equal to '01','02', '04', '08'
RULE-491	If a claim is a non-denied claim from an IP file, then the admission date value reported must be a valid date of the form CCYYMMDD.
RULE-7208	If a claim is a non-denied claim and is an original claim or a replacement/resubmission claim payment from an IP file, and is a Medicaid or Medicaid-expansion CHIP FFS, Medicaid or Medicaid-expansion CHIP Encounter, separate CHIP FFS or separate CHIP Encounter claim, then the admission date value must be populated.
RULE-7198	If plan ID is populated on a non-denied Medicaid, S-CHIP, or Other encounter from an IP file, then the plan ID must be equal to the plan ID on a managed care main segment from an MCR file where the admission date on the claim is within the contract effective and end dates of the managed care main segment.
RULE-7194	If plan ID is populated on a non-denied, non-void Medicaid, S-CHIP, or Other encounter from an IP file, then the plan ID must be equal to the plan ID on a managed care participation segment from an ELG file with the same MSIS ID and where the admission date on the claim is within the effective and end dates of the managed care participation segment.
RULE-575	If Medicaid covered inpatient days, admission date, and discharge date are populated on a non-denied claim from an IP file, then the Medicaid covered inpatient days value reported must be less than or equal to double the number of days between admission date reported and discharge date reported, plus one day.
RULE-495	If a non-denied IP claim has a value populated for admission date, and the primary demographics eligibility segment has a value populated for date of death, then the claim admission date is less than or equal to date of death.
RULE-494	If discharge date and admission date are populated on a non-denied claim from an IP file, then the admission date value reported must be before or equal to the discharge date value reported.
RULE-493	If the admission date and adjudication date are populated on a non-denied, beneficiary-specific Medicaid or S-CHIP claim from an IP file, then the admission date value reported must be before the adjudication date value reported.

Measure ID	Measure Name
RULE-335	% of claim headers with an MSIS ID not enrolled on Admission Date
RULE-7782	% of claim headers with an MSIS ID not enrolled on Admission Date
RULE-7932	% of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date
RULE-7924	% of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date
RULE-7897	% of claim headers with an MSIS ID not enrolled on Admission Date
RULE-7715	% missing: ADMISSION-DATE (CIP00002)
RULE-7806	% missing: ADMISSION-DATE (CIP00002)
RULE-7198	% of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period
RULE-7194	% of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period
RULE-7439	% of claim headers with a BILLING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Admission Date
RULE-7642	% of claim headers with an MSIS ID not enrolled on Admission Date
RULE-7382	% missing: ADMISSION-DATE (CIP00002)
MIS-79-001-1	% missing: ADMISSION-DATE (CIP00002)
MIS-21-001-1	% missing: ADMISSION-DATE (CIP00002)
RULE-689	% of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service
FFS-1-008-1	% of claim headers with Admission Date within the past year
MIS-55-001-1	% missing: ADMISSION-DATE (CIP00002)
ALL-21-001-1	% of BILLING-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Admission Date
ALL-14-005-5	% of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Admission Date
ALL-14-001-1	% of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Admission Date
ALL-13-003-5	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related
ALL-13-003-3	% of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services
MIS-2-003-3	% missing: ADMISSION-DATE (CIP00002)
MCR-31-006-6	% of MSIS IDs enrolled on Admission Date
MCR-31-001-1	% of MSIS IDs enrolled on Admission Date
FFS-25-005-5	% of MSIS IDs enrolled on Admission Date
FFS-25-001-1	% of MSIS IDs enrolled on Admission Date
MCR-3-008-1	% of claim headers with Admission Date within the past year
MCR-1-008-1	% of claim headers with Admission Date within the past year
FFS-3-008-1	% of claim headers with Admission Date within the past year

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT044	CLT.002.044	ADMISSION-DATE	CLT00002	CLAIM-HEADER-RECORD-LT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CIP.002.094	UPDATE	File segment	None	25
09/16/2024	4.0.0	CIP.002.094	ADD	N/A		Created