CIP.002.199

PATIENT-STATUS

Data Element

DE Number

CIP199

System DE Number

CIP.002.199

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	A code indicating the patient's status as of the last day the claim covers. Values used are from UB-04. This is also referred to as patient discharge status. A valid list of codes can be purchased at: https://www.nubc.org/license
Size	X(2)
FLF Start Position	1033
FLF Stop Position	1034
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 2 characters 2. Value must be in Patient Status List (VVL) 3. Mandatory 4. When value in [20,40,41,42], then associated Discharge Date (CIP.002.096) must be less than or equal to Date of Death (ELG.002.025)

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.

A valid list of Patient Status codes can be purchased at https://www.nubc.org/license

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

RULE ID	RULE Definition
RULE-6897	If a claim is a non-denied claim from an IP file, then the patient status value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-718	If the patient status is populated on a non-denied claim from an IP file, then the patient status value reported must be in the list of valid values for patient status.

Measure ID	Measure Name
MCR-3-010-5	% of claim headers with Patient Status of other institution
RULE-7805	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
MCR-56R-001-1	% of Plan IDs over the threshold for MCR-56P-001-1 (% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date, by Plan ID)
MCR-56P-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date, by Plan ID
MIS-79-042-42	% missing: PATIENT-STATUS (CIP00002)
MIS-21-042-42	% missing: PATIENT-STATUS (CIP00002)
MCR-57-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
MCR-56-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
FFS-48-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
FFS-47-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
MIS-2-039-39	% missing: PATIENT-STATUS (CIP00002)
MCR-3-012-6	% of claim headers with Patient Status of still a patient
MCR-3-011-2	% of claim headers with deceased Patient Status
FFS-1-009-4	% of claim headers with home Patient Status
MCR-3-009-4	% of claim headers with home Patient Status
MCR-1-011-6	% of claim headers with Patient Status of still a patient
MCR-1-010-5	% of claim headers with Patient Status of other institution
MCR-1-010-2	% of claim headers with deceased Patient Status
MCR-1-009-4	% of claim headers with home Patient Status
FFS-3-012-6	% of claim headers with Patient Status of still a patient
FFS-3-011-2	% of claim headers with deceased Patient Status
FFS-3-010-5	% of claim headers with Patient Status of other institution
FFS-3-009-4	% of claim headers with home Patient Status
FFS-1-012-18	% of claim headers with Patient Status of still a patient
FFS-1-011-2	% of claim headers with deceased Patient Status
FFS-1-010-17	% of claim headers with Patient Status of other institution

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT141	CLT.002.141	PATIENT-STATUS	CLT00002	CLAIM-HEADER-RECORD-LT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
04/09/2026	4.0.31	CIP.002.199	UPDATE	Medicaid valid value info		A valid list of Patient Status codes can be purchased at https://www.nubc.org/license
09/16/2024	4.0.0	CIP.002.199	UPDATE	File segment	None	25
09/16/2024	4.0.0	CIP.002.199	ADD	N/A		Created