Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
---|---|---|---|---|---|
No data available in table |
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Data Element
CIP221
CIP.002.221
Definition | The National Provider ID (NPI) of the health home provider. |
---|---|
Size | X(10) |
FLF Start Position | 1368 |
FLF Stop Position | 1377 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be 10 digits 2. Value must have an associated Provider Identifier Type (PRV.005.007) equal to "2" 3. Value must exist in the NPPES NPI data file 4. Conditional |
RULE ID | RULE Definition |
---|---|
RULE-6274 | If a claim is a non-denied claim from an IP file, then the health home provider NPI value reported must be compatible with specified T-MSIS picture format: X(10). |
RULE-745 | If the health home provider NPI is populated on a non-denied claim from an IP file, then the health home provider NPI value reported must be in the list of valid values. |
RULE-747 | If a claim is a non-denied claim from an IP file that is not an encounter claim and the home health provider NPI is populated, then the prov identifier type on the provider identifiers segment must be populated with the value '2'. |
RULE-7478 | If a claim is a non-denied, non-void claim from an IP file and the health home provider NPI is populated then claim header health home provider NPI exists in the NPPES NPI data file. |
DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
---|---|---|---|---|
CLT167 | CLT.002.167 | HEALTH-HOME-PROVIDER-NPI | CLT00002 | CLAIM-HEADER-RECORD-LT |
COT146 | COT.002.146 | HEALTH-HOME-PROVIDER-NPI | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX104 | CRX.002.104 | HEALTH-HOME-PROVIDER-NPI | CRX00002 | CLAIM-HEADER-RECORD-RX |
Published Date | Data Guide Version | Data Element | Action | Field | Before | After |
---|---|---|---|---|---|---|
09/12/2024 | 3.29.0 | CIP.002.221 | UPDATE | Coding requirement | 1. Value must be 10 digits2. Value must have an associated Provider Identifier Type (PRV.005.007) equal to '2' 3. Value must exist in the NPPES NPI data file4. Conditional | 1. Value must be 10 digits2. Value must have an associated Provider Identifier Type (PRV.005.007) equal to "2"3. Value must exist in the NPPES NPI data file4. Conditional |
08/28/2023 | 3.12.0 | CIP.002.221 | 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. Value must have an associated Provider Identifier Type equal to '2'3. Conditional | 1. Value must be 10 digits2. Value must have an associated Provider Identifier Type (PRV.005.007) equal to '2' 3. Value must exist in the NPPES NPI data file4. Conditional |
06/24/2022 | 3.0.0 | HEALTH-HOME-PROVIDER-NPI | UPDATE | Data Dictionary | |DE No|Data Element Name|Definition| |CIP221|HEALTH-HOME-PROVIDER-NPI|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).| |CLT167|HEALTH-HOME-PROVIDER-NPI|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).| |COT146|HEALTH-HOME-PROVIDER-NPI|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).| |CRX104|HEALTH-HOME-PROVIDER-NPI|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| |CIP221|HEALTH-HOME-PROVIDER-NPI|The National Provider ID (NPI) of the health home provider.| |CLT167|HEALTH-HOME-PROVIDER-NPI|The National Provider ID (NPI) of the health home provider.| |COT146|HEALTH-HOME-PROVIDER-NPI|The National Provider ID (NPI) of the health home provider.| |CRX104|HEALTH-HOME-PROVIDER-NPI|The National Provider ID (NPI) of the health home provider.| |