CRX.002.098

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

THIRD-PARTY-COINSURANCE-AMOUNT-PAID

Data Element

DE Number

CRX098

System DE Number

CRX.002.098

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	The amount of money paid by a third party on behalf of the beneficiary towards coinsurance.
Size	S9(11)V99
FLF Start Position	746
FLF Stop Position	758
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 3. Situational

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

RULE ID	RULE Definition
RULE-1885	If a claim is a non-denied claim from an RX file, then the third party coinsurance amount value paid reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP216	CIP.002.216	THIRD-PARTY-COINSURANCE-AMOUNT-PAID	CIP00002	CLAIM-HEADER-RECORD-IP
CLT163	CLT.002.163	THIRD-PARTY-COINSURANCE-AMOUNT-PAID	CLT00002	CLAIM-HEADER-RECORD-LT
COT140	COT.002.140	THIRD-PARTY-COINSURANCE-AMOUNT-PAID	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/29/2023	3.12.0	CRX.002.098	UPDATE	Necessity	Optional	Situational
08/23/2023	3.12.0	CRX.002.098	UPDATE	Coding requirement	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Optional	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Situational
05/13/2022	3.0.0	CRX098	UPDATE	Data Dictionary	N/A	\|DE NO\| DATA ELEMENT NAME\|NECESSITY \|DEFINITION\|CODING REQUIREMENT\|FILENAME\| FILE SEGMENT NAME CRX098\|THIRD-PARTY-COINSURANCE-AMOUNT-PAID\|Optional\|The amount of money paid by a third party on behalf of the beneficiary towards coinsurance.\|1. Value must be between -99999999999.99 and 99999999999.99, 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ), 3.Optional\|CLAIMRX\|CLAIM-HEADER-RECORD-RX-CRX00002