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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

PROCEDURE-CODE

Data Element

DE Number

CRX182

System DE Number

CRX.003.182

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00003

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The procedure code (e.g., CPT, HCPCS, or other procedure code that is not an NDC or UDI) reported by a pharmacy on their NCPDP transaction.
Size X(6)
FLF Start Position 629
FLF Stop Position 634
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must not be more than 6 characters
2. Value must be in Procedure Code List (VVL)
3. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
COT169 COT.003.169 PROCEDURE-CODE COT00003 CLAIM-LINE-RECORD-OT