CIP.002.121

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TMSIS Dataguide

Medicaid.gov

Version:

OTHER-INSURANCE-IND

Data Element

DE Number

CIP121

System DE Number

CIP.002.121

File Name

CIP - CLAIM INPATIENT

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The field denotes whether the insured party is covered under an other insurance plan other than Medicare or Medicaid.
Size	X(1)
FLF Start Position	482
FLF Stop Position	482
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in Other Insurance Indicator List (VVL) 3. Situational

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

RULE ID	RULE Definition
RULE-549	If the other insurance indicator is populated on a non-denied claim from an IP file, then the other insurance indicator reported must be found in the list of valid values.
RULE-7025	If a claim is a non-denied claim from an IP file, then the other insurance indicator value reported must be compatible with specified T-MSIS picture format: X(1).

Measure ID	Measure Name
TPL-2-001-1	% of claim headers with OTHER-INSURANCE-IND = 1
TPL-3-001-1	% of claim headers with OTHER-INSURANCE-IND = 1
TPL-4-001-1	% of claim headers with OTHER-INSURANCE-IND = 1
TPL-5-001-1	% of claim headers with OTHER-INSURANCE-IND = 1
MIS-2-037-37	% missing: OTHER-INSURANCE-IND (CIP00002)
MIS-21-039-39	% missing: OTHER-INSURANCE-IND (CIP00002)
MIS-79-039-39	% missing: OTHER-INSURANCE-IND (CIP00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT071	CLT.002.071	OTHER-INSURANCE-IND	CLT00002	CLAIM-HEADER-RECORD-LT
COT057	COT.002.057	OTHER-INSURANCE-IND	COT00002	CLAIM-HEADER-RECORD-OT
CRX048	CRX.002.048	OTHER-INSURANCE-IND	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/10/2025	4.0.13	CIP.002.121	UPDATE	Necessity	Conditional	Situational
07/10/2025	4.0.13	CIP.002.121	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in Other Insurance Indicator List (VVL)3. Conditional	1. Value must be 1 character2. Value must be in Other Insurance Indicator List (VVL)3. Situational
02/27/2025	4.0.3	CIP.002.121	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in Other Insurance Indicator List (VVL)3. Value must be in [0,1] or not populated4. Conditional	1. Value must be 1 character2. Value must be in Other Insurance Indicator List (VVL)3. Conditional
09/16/2024	4.0.0	CIP.002.121	UPDATE	File segment	None	25
09/16/2024	4.0.0	CIP.002.121	ADD	N/A		Created