CIP.002.301

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TMSIS Dataguide

Medicaid.gov

Version:

BILLING-PROV-STATE

Data Element

DE Number

CIP301

System DE Number

CIP.002.301

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	Billing provider address state code from X12 837I loop 2010AA.
Size	X(2)
FLF Start Position	1518
FLF Stop Position	1519
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must not be more than 2 characters 2. Value must be in State Code List (VVL) 3. Mandatory

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

RULE ID	RULE Definition
RULE-8931	if a claim is a non-denied claim from a IP file, then the billing provider state value reported must be compatible with the specified T-MSIS picture format: X(2).
RULE-9057	if the billing provider state is populated on a non-denied claim header from a IP file, then the billing provider state value reported must be found in the list of valid values for 'STATE'.
RULE-9159	if the CLAIM-HEADER-RECORD-IP segment is populated from a CIP file, then the BILLING-PROV-STATE must be populated for non-denied claims.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT247	CLT.002.247	BILLING-PROV-STATE	CLT00002	CLAIM-HEADER-RECORD-LT
COT239	COT.002.239	BILLING-PROV-STATE	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CIP.002.301	UPDATE	File segment	None	25
09/16/2024	4.0.0	CIP.002.301	ADD	N/A		Created