CLT.002.147

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

ICF-IID-DAYS

Data Element

DE Number

CLT147

System DE Number

CLT.002.147

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	The number of days of intermediate care for individuals with an intellectual disability that were paid for in whole or in part by Medicaid. If value exceeds 99998 days, code as 99998. (e.g., code 100023 as 99998).
Size	S9(5)
FLF Start Position	935
FLF Stop Position	939
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 5 digits or less 2. Conditional 3. Value is mandatory when associated Type of Service (CLT.003.211) = '046' 4. Value must be less than or equal to the number of days between (ending date of service minus beginning date of service) plus one day 5. When populated, if value is greater than 0 and less than 99998, then Level of Care Status (ELG.005.088) for the associated MSIS Identification Number (CLT.002.022) must equal '004' (ICF/IID) for the same month as the begin and end date of service

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

RULE ID	RULE Definition
RULE-1149	If a claim is a non-denied claim from an LT file, then the ICF IID days value reported must be compatible with specified T-MSIS picture format: S9(5).
RULE-1150	If beginning date of service and ending date of service are populated on a non-denied LT claim, then the ICF-IID days value must be less than or equal to the days between the beginning date of service and ending date of service plus one day.
RULE-1151	If type of service is intermediate care facility (ICF/IIDICF/IID) services on a non-denied claim line from an LT file, then ICF IID days must be populated on the claim.

Measure ID	Measure Name
FFS-5-011-29	Average # of long-term care days, exclude 0
FFS-5-021-4	% of claim headers with TYPE-OF-SERVICE = 46 (intermediate care facility (ICF/IIDICF/IID) services) without intermediate care facility days
FFS-7-011-19	Average # of long-term care days, exclude 0
MCR-5-011-20	Average # of long-term care days, exclude 0
MCR-5-017-4	% of claim headers with TYPE-OF-SERVICE = 46 (intermediate care facility (ICF/IIDICF/IID) services) without intermediate care facility days
MCR-7-011-19	Average # of long-term care days, exclude 0
MCR-7-016-4	% of claim headers with TYPE-OF-SERVICE = 46 (intermediate care facility (ICF/IIDICF/IID) services) without intermediate care facility days
MIS-4-020-20	% missing: ICF-IID-DAYS (CLT00002)
MIS-23-021-21	% missing: ICF-IID-DAYS (CLT00002)
MIS-81-021-21	% missing: ICF-IID-DAYS (CLT00002)
FFS-7-016-4	% of records with TYPE-OF-SERVICE = 46 (Intermediate Care Facility Services) without ICF Days

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After