COT.004.283

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TMSIS Dataguide

Medicaid.gov

Version:

DIAGNOSIS-CODE-FLAG

Data Element

DE Number

COT283

System DE Number

COT.004.283

File Name

COT - CLAIM OTHER

File Segment Number

File Segment Name

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Flag used to identify wither the associated Diagnosis Code value is a ICD-9 or ICD-10 code.
Size	X(1)
FLF Start Position	134
FLF Stop Position	134
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 1 character 2. Value must be in Diagnosis Code Flag 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-9014	If a claim is a non-denied claim from an OT file, then the diagnosis code flag value reported must be compatible with the specified T-MSIS picture format: X(1).
RULE-9125	If the diagnosis code flag is populated on a non-denied claim header from a OT file, then the diagnosis code flag reported must be found in the list of valid values for 'DIAGNOSIS-CODE-FLAG'.
RULE-9210	if the CLAIM-DX-OT segment is populated from a COT file, then the DIAGNOSIS-CODE-FLAG must be populated for non-denied claim

Measure ID	Measure Name
MIS-93-001-2	% missing: DIAGNOSIS-CODE-FLAG (COT00004)
MIS-97-001-2	% missing: DIAGNOSIS-CODE-FLAG (COT00004)
RULE-9226	% of claim headers with a Procedure Code indicating a dental claim and non-missing Diagnosis Code Flag that have a missing Diagnosis Code

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP331	CIP.004.331	DIAGNOSIS-CODE-FLAG	CIP00004	CLAIM-DX-IP
CLT277	CLT.004.277	DIAGNOSIS-CODE-FLAG	CLT00004	CLAIM-DX-LT
CRX205	CRX.004.205	DIAGNOSIS-CODE-FLAG	CRX00004	CLAIM-DX-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
10/08/2024	4.0.0	COT.004.283	UPDATE	Coding requirement	1. Value must be 1 character2. Value must be in Diagnosis Code Flag List (VVL)3. Mandatory1. Value must be 1 character2. Value must be in Diagnosis Code Flag List (VVL)3. Mandatory	1. Value must be 1 character2. Value must be in Diagnosis Code Flag List (VVL)3. Mandatory
09/16/2024	4.0.0	COT.004.283	UPDATE	File segment	None	37
09/16/2024	4.0.0	COT.004.283	ADD	N/A		Created