CRX.002.053

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

FUNDING-CODE

Data Element

DE Number

CRX053

System DE Number

CRX.002.053

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code to indicate the source of non-federal share funds.
Size	X(2)
FLF Start Position	339
FLF Stop Position	340
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Funding Code List (VVL) 2. Value must be 1 character 3. Value must be populated if TYPE-OF-CLAIM <> ‘3', ‘C’, ‘W’, or '6’ 4. 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-1812	If the funding code is populated on a non-denied claim from an RX file, then the funding code reported must be found in the list of valid values.
RULE-6595	If a claim is a non-denied claim from an RX file, then the funding code reported must be compatible with specified T-MSIS picture format: X(2).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP126	CIP.002.126	FUNDING-CODE	CIP00002	CLAIM-HEADER-RECORD-IP
CLT076	CLT.002.076	FUNDING-CODE	CLT00002	CLAIM-HEADER-RECORD-LT
COT062	COT.002.062	FUNDING-CODE	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
06/02/2023	3.8.0	CRX.002.053	UPDATE	Coding requirement	1. Value must be in Funding Code List (VVL)2. Value must be 1 character3. Only required if Type-of-claim is not equal to '3', 'C', 'W', '6'4. Conditional	1. Value must be in Funding Code List (VVL)2. Value must be 1 character3. Value must be populated if TYPE-OF-CLAIM <> ‘3', ‘C’, ‘W’, or '6’4. Conditional
06/02/2023	3.8.0	CRX.002.053	UPDATE	Coding requirement	Value must be in Funding Code List (VVL)2. Value must be 1 character3. Only required if Type-of-claim is not equal to '3', 'C', 'W', '6'4. Conditional	1. Value must be in Funding Code List (VVL)2. Value must be 1 character3. Only required if Type-of-claim is not equal to '3', 'C', 'W', '6'4. Conditional
06/01/2023	3.8.0	CRX.002.053	UPDATE	Coding requirement	1. Value must be in Funding Code List (VVL)2. Value must be 1 character3. Conditional	Value must be in Funding Code List (VVL)2. Value must be 1 character3. Only required if Type-of-claim is not equal to '3', 'C', 'W', '6'4. Conditional
05/31/2023	3.8.0	CRX.002.053	UPDATE	Necessity	Mandatory	Conditional
05/31/2023	3.8.0	CRX.002.053	UPDATE	Coding requirement	1. Value must be in Funding Code List (VVL)2. Value must be 1 character3. Mandatory	1. Value must be in Funding Code List (VVL)2. Value must be 1 character3. Conditional