CLT.002.033

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide

Medicaid.gov

Version 3.27.0

DIAGNOSIS-CODE-FLAG-2

Data Element

DE Number

CLT033

System DE Number

CLT.002.033

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Flag used to identify if associated Diagnosis Code field is reported with ICD-9 or ICD-10 code. Each Diagnosis Code Flag is associated with one, and only one, Diagnosis Code in a given file segment record. For example, Diagnosis Code n is associated with Diagnosis Code Flag n, where n can be any integer greater than or equal to 1.
Size	X(1)
FLF Start Position	184
FLF Stop Position	184
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Diagnosis Code Flag List (VVL) 2. Value must be 1 character 3. Conditional 4. Value should not be populated, if the associated diagnosis code is not populated

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

RULE ID	RULE Definition
RULE-6995	If a claim is a non-denied claim from an LT file, then the diagnosis code flag 5 value reported must be compatible with specified T-MSIS picture format: X(1).
RULE-896	If the second diagnosis code is populated and the second 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 second diagnosis code must be a valid value from the list of values for ICD-9 or ICD-10 codes, respectively.
RULE-900	If the diagnosis code flag 2 is populated on a non-denied claim from an LT file, then the diagnosis code flag 2 value reported must be in the list of valid values for diagnosis code flag.

Measure ID	Measure Name
MIS-4-015-15	% missing: DIAGNOSIS-CODE-FLAG-2 (CLT00002)
MIS-23-016-16	% missing: DIAGNOSIS-CODE-FLAG-2 (CLT00002)
MIS-81-016-16	% missing: DIAGNOSIS-CODE-FLAG-2 (CLT00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP036	CIP.002.036	DIAGNOSIS-CODE-FLAG-2	CIP00002	CLAIM-HEADER-RECORD-IP
COT031	COT.002.031	DIAGNOSIS-CODE-FLAG-2	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After