CIP.002.105

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

CHECK-NUM

Data Element

DE Number

CIP105

System DE Number

CIP.002.105

File Name

CIP - CLAIM INPATIENT

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The check or electronic funds transfer number.
Size	X(15)
FLF Start Position	464
FLF Stop Position	478
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 15 characters or less 2. Value must have an associated Check Effective Date 3. Value must not contain a pipe or asterisk symbols 4. Conditional

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

RULE ID	RULE Definition
RULE-515	If the check number is populated on a non-denied claim from an IP file, then the check number reported must be found in the list of valid values.
RULE-6929	If a claim line is a non-denied claim line from an IP file, then the check number value reported must be compatible with specified T-MSIS picture format: X(15).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT057	CLT.002.057	CHECK-NUM	CLT00002	CLAIM-HEADER-RECORD-LT
COT042	COT.002.042	CHECK-NUM	COT00002	CLAIM-HEADER-RECORD-OT
CRX033	CRX.002.033	CHECK-NUM	CRX00002	CLAIM-HEADER-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After