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TMSIS Dataguide Medicaid.gov
Version 3.27.0

CLAIM-DENIED-INDICATOR

Data Element

DE Number

CRX094

System DE Number

CRX.002.094

File Segment Number

CRX00002

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Definition

An indicator to identify a claim that the state refused pay in its entirety.

Size X(1)
FLF Start Position 694
FLF Stop Position 694
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value must be in Claim Denied Indicator List (VVL)
2. If value is '0', then Claim Status Category must equal "F2"
3. Value must be 1 character
4. Mandatory

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
CIP212 CIP.002.212 CLAIM-DENIED-INDICATOR CIP00002 CLAIM-HEADER-RECORD-IP
CLT159 CLT.002.159 CLAIM-DENIED-INDICATOR CLT00002 CLAIM-HEADER-RECORD-LT
COT136 COT.002.136 CLAIM-DENIED-INDICATOR COT00002 CLAIM-HEADER-RECORD-OT