CIP.002.184

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

ADMITTING-PROV-NPI-NUM

Data Element

DE Number

CIP184

System DE Number

CIP.002.184

File Name

CIP - CLAIM INPATIENT

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The National Provider ID (NPI) of the doctor responsible for admitting a patient to a hospital or other inpatient health facility.
Size	X(10)
FLF Start Position	1028
FLF Stop Position	1037
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 10 digits 2. Conditional 3. Value must have an associated Provider Identifier Type equal to '2' 4. Value must exist in the NPPES NPI File

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

RULE ID	RULE Definition
RULE-696	If the admitting provider NPI number is populated on a non-denied claim from an IP file, then the admitting provider NPI number value reported must be in the list of valid values.
RULE-7032	If a claim line is a non-denied claim line from an IP file, then the admitting provider NPI number value reported must be compatible with specified T-MSIS picture format: X(10).
RULE-7476	If a claim is a non-denied, non-void claim from an IP file and the admitting provider NPI num is populated then claim header admitting provider NPI num exists in the NPPES NPI data file.

Measure ID	Measure Name
MIS-2-004_1-60	% missing: ADMITTING-PROV-NPI-NUM (CIP00002)
MIS-21-002-2	% missing: ADMITTING-PROV-NPI-NUM (CIP00002)
MIS-79-002-2	% missing: ADMITTING-PROV-NPI-NUM (CIP00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT174	CLT.002.174	ADMITTING-PROV-NPI-NUM	CLT00002	CLAIM-HEADER-RECORD-LT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/15/2023	3.12.0	CIP.002.184	UPDATE	Coding requirement	1. Value must be 10 digits, consisting of 9 numeric digits followed by one check digit calculated using the Luhn formula (algorithm)2. Conditional3. Value must have an associated Provider Identifier Type equal to '2'	1. Value must be 10 digits2. Conditional3. Value must have an associated Provider Identifier Type equal to '2'4. Value must exist in the NPPES NPI File
05/13/2022	3.0.0	CIP184, CLT006, COT006, CRX006, ELG006, MCR006, PRV006, TPL006, CIP127, CLT077, COT063, CRX054, ELG111, TPL044, TPL045, CIP093, CIP088, PRV043, PRV064, PRV076, PRV129, COT191	UPDATE	Data Dictionary	DE NO\| DATA ELEMENT NAME\|NECESSITY\| CIP184\|ADMITTING-PROV-NPI-NUM\|\| CLT006\|FILE-NAME\|\| CRX006\|FILE-NAME\|\| ELG006\|FILE-NAME\|\| MCR006\|FILE-NAME\|\| PRV006\|FILE-NAME\|\| TPL006\|FILE-NAME\|\| CIP127\|FUNDING-SOURCE-NONFEDERAL-SHARE\|\| CLT077\|FUNDING-SOURCE-NONFEDERAL-SHARE\|\| COT063\|FUNDING-SOURCE-NONFEDERAL-SHARE\|\| CRX054\|FUNDING-SOURCE-NONFEDERAL-SHARE\|\| ELG111\|HEALTH-HOME-ENTITY-EFF-DATE\|\| TPL044\|POLICY-OWNER-FIRST-NAME\|\| TPL045\|POLICY-OWNER-LAST-NAME\|\| CIP093\|PROCEDURE-CODE-DATE-6\|\| CIP088\|PROCEDURE-CODE-FLAG-5\|\| PRV043\|PROV-LOCATION-ID\|\| PRV064\|PROV-LOCATION-ID\|\| PRV076\|PROV-LOCATION-ID\|\| PRV129\|PROV-LOCATION-ID\|\| COT191\|SERVICING-PROV-TAXONOMY\|\|	DE NO\| DATA ELEMENT NAME\|NECESSITY\| CIP184\|ADMITTING-PROV-NPI-NUM\|Conditional\| CLT006\|FILE-NAME\|Mandatory\| CRX006\|FILE-NAME\|Mandatory\| ELG006\|FILE-NAME\|Mandatory\| MCR006\|FILE-NAME\|Mandatory\| PRV006\|FILE-NAME\|Mandatory\| TPL006\|FILE-NAME\|Mandatory\| CIP127\|FUNDING-SOURCE-NONFEDERAL-SHARE\|Conditional\| CLT077\|FUNDING-SOURCE-NONFEDERAL-SHARE\|Conditional\| COT063\|FUNDING-SOURCE-NONFEDERAL-SHARE\|Conditional\| CRX054\|FUNDING-SOURCE-NONFEDERAL-SHARE\|Conditional\| ELG111\|HEALTH-HOME-ENTITY-EFF-DATE\|Mandatory\| TPL044\|POLICY-OWNER-FIRST-NAME\|Mandatory\| TPL045\|POLICY-OWNER-LAST-NAME\|Mandatory\| CIP093\|PROCEDURE-CODE-DATE-6\|Conditional\| CIP088\|PROCEDURE-CODE-FLAG-5\|Conditional\| PRV043\|PROV-LOCATION-ID\|Mandatory\| PRV064\|PROV-LOCATION-ID\|Mandatory\| PRV076\|PROV-LOCATION-ID\|Mandatory\| PRV129\|PROV-LOCATION-ID\|Mandatory\| COT191\|SERVICING-PROV-TAXONOMY\|Conditional\|
06/24/2022	3.0.0	ADMITTING-PROV-NPI-NUM	UPDATE	Data Dictionary	\|DE No\|Data Element Name\|Definition\| \|CLT174\|ADMITTING-PROV-NPI-NUM\|A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by CMS. Healthcare providers acquire their unique 10-digit NPIs to identify themselves in a standard way throughout their industry. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).\|	\|DE No\|Data Element Name\|Definition\| \|CLT174\|ADMITTING-PROV-NPI-NUM\|The National Provider ID (NPI) of the doctor responsible for admitting a patient to a hospital or other inpatient health facility.\|
06/24/2022	3.0.0	ADMITTING-PROV-NPI-NUM	UPDATE	Data Dictionary	\|DE No\|Data Element Name\|Definition\| \|CIP184\|ADMITTING-PROV-NPI-NUM\|A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by CMS. Healthcare providers acquire their unique 10-digit NPIs to identify themselves in a standard way throughout their industry. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).\|	\|DE No\|Data Element Name\|Definition\| \|CIP184\|ADMITTING-PROV-NPI-NUM\|The National Provider ID (NPI) of the doctor responsible for admitting a patient to a hospital or other inpatient health facility.\|