Reporting Reminder History
| Date | Description of Change |
|---|---|
| 08/05/2021 | Original reporting reminder issued |
| 06/24/2022 |
Reporting reminder updated in correspondence with the V3.0.0 data dictionary update:
|
Topic Description
Reporting complete claims classifier data elements is a T-MSIS Priority Item. This reporting reminder focuses on reporting claims classifier data elements: Type-of-Service, Type-of-Claim, Program-Type, CMS-64-Category-for-Federal-Reimbursement, and IHS-SERVICE-IND[1] within the Claims files in T-MSIS.
Impacted Data Elements
- TYPE-OF-SERVICE (CIP257,CLT211,COT186, CRX134)
- TYPE-OF-CLAIM (CIP100, CLT052, COT037, CRX029)
- PROGRAM-TYPE (CIP129, CLT079, COT065, CRX055)
- CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CIP269, CLT219, COT210, CRX149)
- IHS-SERVICE-IND (CIP296, CLT243, COT234, CRX172,)[1]
Reporting Reminder
T-MSIS includes data elements that help classify the services provided or the program and/or benefit under which the claim was covered. TYPE-OF-SERVICE, TYPE-OF-CLAIM, PROGRAM-TYPE, CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT, and IHS-SERVICE-IND[1] are data elements that help classify these services. These data elements are required and are applicable to all or nearly all claims in all file types.
CMS will report a possible data quality issue when the following occur:
- There are more than a small percentage of claims for which TYPE-OF-SERVICE, TYPE-OF-CLAIM, or CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT is missing; or
- The percentage of claims for which PROGRAM-TYPE equals 01 (EPSDT), 02 (Family Planning), or 04 (Federally Qualified Health Centers (FQHC)) are outside of a reasonable range.
Please refer to the T-MSIS data dictionary for specific coding requirements for each data element.
[1] This is a new data element as of T-MSIS Data Dictionary V3.0.0.