CRX.004.204

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TMSIS Dataguide

Medicaid.gov

Version:

DIAGNOSIS-SEQUENCE-NUMBER

Data Element

DE Number

CRX204

System DE Number

CRX.004.204

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The order in which the diagnosis occurred on the provider's claim for a given type of diagnosis code (e.g., an NCPDP claim can have up to 5 diagnosis codes).
Size	9(2)
FLF Start Position	132
FLF Stop Position	133
Segment Key Field Identifier	7
Coding Requirements	1. Value must be in [01-24] 2. Situational 3. Value must be 2 digits

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

RULE ID	RULE Definition
RULE-9049	If a claim is a non-denied claim from a RX file, then the diagnosis sequence number value reported must be compatible with the specified T-MSIS picture format: 9(2).
RULE-9223	if the CLAIM-DX-RX segment is populated from a CRX file, then the DIAGNOSIS-SEQUENCE-NUMBER must be populated for non-denied claim

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP330	CIP.004.330	DIAGNOSIS-SEQUENCE-NUMBER	CIP00004	CLAIM-DX-IP
CLT276	CLT.004.276	DIAGNOSIS-SEQUENCE-NUMBER	CLT00004	CLAIM-DX-LT
COT282	COT.004.282	DIAGNOSIS-SEQUENCE-NUMBER	COT00004	CLAIM-DX-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/17/2025	4.0.14	CRX.004.204	UPDATE	Necessity	Conditional	Situational
07/17/2025	4.0.14	CRX.004.204	UPDATE	Coding requirement	1. Value must be in [01-24]2. Conditional3. Value must be 2 digits	1. Value must be in [01-24]2. Situational3. Value must be 2 digits
03/14/2025	4.0.4	CRX.004.204	UPDATE	Coding requirement	1. Value must be in [01-24]2. Conditional	1. Value must be in [01-24]2. Conditional3. Value must be 2 digits
02/27/2025	4.0.3	CRX.004.204	UPDATE	Necessity	Mandatory	Conditional
02/27/2025	4.0.3	CRX.004.204	UPDATE	Coding requirement	1. Value must be in [01-24]2. Mandatory	1. Value must be in [01-24]2. Conditional
09/16/2024	4.0.0	CRX.004.204	UPDATE	File segment	None	42
09/16/2024	4.0.0	CRX.004.204	ADD	N/A		Created