CIP.003.248

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

IMMUNIZATION-TYPE

Data Element

DE Number

CIP248

System DE Number

CIP.003.248

File Name

CIP - CLAIM INPATIENT

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-IP

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	This field identifies the type of immunization provided in order to track additional detail not currently contained in Current Procedural Terminology (CPT) codes.
Size	X(2)
FLF Start Position	187
FLF Stop Position	188
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Immunization Type List (VVL) 2. Value must be 2 characters 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-6566	If a claim line is a non-denied claim line from an IP file, then the immunization type value reported must be compatible with specified T-MSIS picture format: X(2).
RULE-793	If a non-denied claim from an IP file has a value populated for immunization type, then the immunization type must be found in the list of valid values.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CLT201	CLT.003.201	IMMUNIZATION-TYPE	CLT00003	CLAIM-LINE-RECORD-LT
COT173	COT.003.173	IMMUNIZATION-TYPE	COT00003	CLAIM-LINE-RECORD-OT
CRX147	CRX.003.147	IMMUNIZATION-TYPE	CRX00003	CLAIM-LINE-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After