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TMSIS Dataguide Medicaid.gov
Version 3.27.0

BORDER-STATE-IND

Data Element

DE Number

CRX082

System DE Number

CRX.002.082

File Segment Number

CRX00002

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Definition

A code to indicate whether an individual received services or equipment across state borders. (The provider location is out of state, but for payment purposes the provider is treated as an in-state provider.)

Size X(1)
FLF Start Position 613
FLF Stop Position 613
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value must be 1 character
2. Value must be in [0, 1] or not populated
3. Value must be in Border State Indicator List (VVL)
4. Conditional

Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP204 CIP.002.204 BORDER-STATE-IND CIP00002 CLAIM-HEADER-RECORD-IP
CLT151 CLT.002.151 BORDER-STATE-IND CLT00002 CLAIM-HEADER-RECORD-LT
COT128 COT.002.128 BORDER-STATE-IND COT00002 CLAIM-HEADER-RECORD-OT