CIP.002.199

PATIENT-STATUS

Data Element

DE Number

CIP199

System DE Number

CIP.002.199

File Name

CIP - CLAIM INPATIENT

File Segment Number

CIP00002

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code indicating the patient's status as of the last day the claim covers. Values used are from UB-04. This is also referred to as patient discharge status. A valid list of codes can be purchased at https://www.nubc.org/license
Size	X(2)
FLF Start Position	1164
FLF Stop Position	1165
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Patient Status List (VVL). 2. Value must be 2 characters 3. Mandatory 4. When value in ["20", "40", "41", "42"], then associated Discharge Date (CIP.002.096) must be less than or equal to Date of Death (ELG.002.025)

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

A valid list of Patient Status codes can be purchased at https://www.nubc.org/license

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

RULE ID	RULE Definition
RULE-6897	If a claim is a non-denied claim from an IP file, then the patient status value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-718	If the patient status is populated on a non-denied claim from an IP file, then the patient status value reported must be in the list of valid values for patient status.

Measure ID	Measure Name
MCR-1-011-6	% of claim headers with Patient Status of still a patient
RULE-7805	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
MCR-56R-001-1	% of Plan IDs over the threshold for MCR-56P-001-1 (% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date, by Plan ID)
MCR-56P-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date, by Plan ID
MIS-79-042-42	% missing: PATIENT-STATUS (CIP00002)
MIS-21-042-42	% missing: PATIENT-STATUS (CIP00002)
MIS-2-039-39	% missing: PATIENT-STATUS (CIP00002)
MCR-57-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
MCR-56-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
MCR-3-012-6	% of claim headers with Patient Status of still a patient
MCR-3-011-2	% of claim headers with deceased Patient Status
MCR-3-010-5	% of claim headers with Patient Status of other institution
MCR-3-009-4	% of claim headers with home Patient Status
FFS-1-009-4	% of claim headers with home Patient Status
MCR-1-010-5	% of claim headers with Patient Status of other institution
MCR-1-010-2	% of claim headers with deceased Patient Status
MCR-1-009-4	% of claim headers with home Patient Status
FFS-48-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
FFS-47-001-1	% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date
FFS-3-012-6	% of claim headers with Patient Status of still a patient
FFS-3-011-2	% of claim headers with deceased Patient Status
FFS-3-010-5	% of claim headers with Patient Status of other institution
FFS-3-009-4	% of claim headers with home Patient Status
FFS-1-012-18	% of claim headers with Patient Status of still a patient
FFS-1-011-2	% of claim headers with deceased Patient Status
FFS-1-010-17	% of claim headers with Patient Status of other institution

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT141	CLT.002.141	PATIENT-STATUS	CLT00002	CLAIM-HEADER-RECORD-LT