CLT.002.027

ADMITTING-DIAGNOSIS-CODE

Data Element

DE Number

CLT027

System DE Number

CLT.002.027

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

CLT00002

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The ICD-9/10-CM Diagnosis Code provided at the time of admission by the physician.
Size	X(7)
FLF Start Position	160
FLF Stop Position	166
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. When populated, a Diagnosis Code Flag is required 2. If associated Diagnosis Code Flag value is "1" (ICD-9), then value must be in ICD-9 Diagnosis Code List (VVL) 3. If associated Diagnosis Code Flag value is "2" (ICD-10), then value must be in ICD-10 Diagnosis Code List (VVL) 4. Value must be a minimum of 3 characters 5. Value must not contain a decimal point 6. If associated Diagnosis Code Flag value is '"1" (ICD-9), value must not exceed 5 characters 7. If associated Diagnosis Code Flag value is "2" (ICD-10), value must not exceed 7 characters 8. When there is more than one diagnosis code on a claim, each value must be unique 9. Conditional

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.

Admitting Diagnosis Code List (ICD-9-CM Diagnosis and Procedure Codes)

Admitting Diagnosis Code List (ICD-10)

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

RULE ID	RULE Definition
RULE-6446	If a claim is a non-denied claim from an LT file, then the admitting diagnosis code value reported must be compatible with specified T-MSIS picture format: X(7).
RULE-890	If the admitting diagnosis code is populated and the admitting diagnosis code flag is for ICD-9 or ICD-10 codes on a non-denied claim from an LT file, then the value for the admitting diagnosis code must be a valid value from the list of values for ICD-9 or ICD-10 codes, respectively.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP030	CIP.002.030	ADMITTING-DIAGNOSIS-CODE	CIP00002	CLAIM-HEADER-RECORD-IP

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
06/24/2022	3.0.0	ADMITTING-DIAGNOSIS-CODE	UPDATE	Data Dictionary	\|DE NO\|DATA ELEMENT NAME\| DEFINITION\| \|CIP030\|ADMITTING-DIAGNOSIS-CODE\|ICD-9 or ICD-10 diagnosis codes used as a tool to group and identify diseases, disorders, symptoms, poisonings, adverse effects of drugs and chemicals, injuries and other reasons for patient encounters. Diagnosis codes should be passed through to T-MSIS exactly as they were submitted by the provider on their claim (with the exception of removing the decimal). For example: 210.5 is coded as "2105".\|	\|DE NO\|DATA ELEMENT NAME\| DEFINITION\| \|CIP030\|ADMITTING-DIAGNOSIS-CODE\|The ICD-9/10-CM Diagnosis Code provided at the time of admission by the physician. Since the Admitting Diagnosis is formulated before all tests and examinations are complete, it may be stated in the form of a problem or symptom and it may differ from any of the final diagnoses recorded in the medical record.\|
06/24/2022	3.0.0	ADMITTING-DIAGNOSIS-CODE	UPDATE	Data Dictionary	\|DE NO\|DATA ELEMENT NAME\| DEFINITION\| \|CLT027\|ADMITTING-DIAGNOSIS-CODE\|ICD-9 or ICD-10 diagnosis codes used as a tool to group and identify diseases, disorders, symptoms, poisonings, adverse effects of drugs and chemicals, injuries and other reasons for patient encounters. Diagnosis codes should be passed through to T-MSIS exactly as they were submitted by the provider on their claim (with the exception of removing the decimal). For example: 210.5 is coded as "2105".\|	\|DE NO\|DATA ELEMENT NAME\| DEFINITION\| \|CLT027\|ADMITTING-DIAGNOSIS-CODE\|The ICD-9/10-CM Diagnosis Code provided at the time of admission by the physician. Since the Admitting Diagnosis is formulated before all tests and examinations are complete, it may be stated in the form of a problem or symptom and it may differ from any of the final diagnoses recorded in the medical record.\|
06/24/2022	3.0.0	ADMITTING-DIAGNOSIS-CODE	UPDATE	Data Dictionary	\|DE No\|Data Element Name\|Definition\| CLT027\|ADMITTING-DIAGNOSIS-CODE\|ICD-9 or ICD-10 diagnosis codes used as a tool to group and identify diseases, disorders, symptoms, poisonings, adverse effects of drugs and chemicals, injuries and other reasons for patient encounters. Diagnosis codes should be passed through to T-MSIS exactly as they were submitted by the provider on their claim (with the exception of removing the decimal). For example: 210.5 is coded as "2105". 1.(GS) value must satisfy the requirements of Diagnosis Code (CE)\|	\|DE No\|Data Element Name\|Definition\| CLT.027\|ADMITTING-DIAGNOSIS-CODE\|The ICD-9/10-CM Diagnosis Code provided at the time of admission by the physician. 1.(GS) value must satisfy the requirements of Diagnosis Code (CE)\|