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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-9226

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with a Procedure Code indicating a dental claim and non-missing Diagnosis Code Flag that have a missing Diagnosis Code
File Type COT
Measure ID RULE-9226
Measure Type Claims percentage
Content area ALL

Validation

Validation Type Inferential

Measure Priority

Measure Priority Medium
Focus Area N/A
Category Utilization

Claim Information

Claim Type Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc
Adjustment Type Original and Replacement
Crossover Type All Indicators

Thresholds

Minimum 0
Maximum 0.001
TA Minimun 0
TA Maximum 0.001
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element PROCEDURE-CODE • DIAGNOSIS-CODE-POINTER-1 • DIAGNOSIS-CODE • DIAGNOSIS-CODE-FLAG
DD Data Element Number COT169 • COT254 • COT284 • COT283

Annotation N/A
Specification RULE-9226