CLT.002.042

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

DIAGNOSIS-CODE-FLAG-5

Data Element

DE Number

CLT042

System DE Number

CLT.002.042

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	211
FLF Stop Position	211
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-6991	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-914	If the fifth diagnosis code is populated on a non-denied claim from an LT file, then the value for the fifth diagnosis code must be a valid value from the list of values for diagnosis codes corresponding to the fifth diagnosis code flag.
RULE-918	If the diagnosis code flag 5 is populated on a non-denied claim from an LT file, then the diagnosis code flag 5 value reported must be in the list of valid values for diagnosis code flag.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP045	CIP.002.045	DIAGNOSIS-CODE-FLAG-5	CIP00002	CLAIM-HEADER-RECORD-IP

Published Date	Data Guide Version	Data Element	Action	Field	Before	After