CIP.002.135

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

NON-COV-CHARGES

Data Element

DE Number

CIP135

System DE Number

CIP.002.135

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 charges for inpatient care, which are not reimbursable by the primary payer. The non-covered charges do not refer to charges not covered for any other service.
Size	S9(11)V99
FLF Start Position	645
FLF Stop Position	657
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 3. 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-573	If a claim is a non-denied claim from an IP file, then the non covered charges value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name
MIS-2-036-36	% missing: NON-COV-CHARGES (CIP00002)
MIS-21-038-38	% missing: NON-COV-CHARGES (CIP00002)
MIS-79-038-38	% missing: NON-COV-CHARGES (CIP00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT085	CLT.002.085	NON-COV-CHARGES	CLT00002	CLAIM-HEADER-RECORD-LT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After