CRX.003.111

MSIS-IDENTIFICATION-NUM

Data Element

DE Number

CRX111

System DE Number

CRX.003.111

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00003

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A state-assigned unique identification number used to identify a Medicaid/CHIP enrolled individual (except on service tracking payments). Value may be an SSN, temporary SSN or State-assigned eligible individual identifier. MSIS Identification Numbers are a unique "key" value used to maintain referential integrity of data distributed over multiples files, segments and reporting periods. See T-MSIS Guidance Document, "CMS Guidance: Reporting Shared MSIS Identification Numbers" for information on reporting the MSIS Identification Numbers ID for pregnant women, unborn children, mothers, and their deemed newborns younger than 1 year of age who share the same MSIS Identification Number. https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47572
Size	X(20)
FLF Start Position	22
FLF Stop Position	41
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Mandatory 2. Value must be 20 characters or less 3. When TYPE-OF-CLAIM is in [4,D,X] (lump sum payment), value must begin with an "&"

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

RULE ID	RULE Definition
RULE-1908	If MSIS identification number is populated on a non-denied claim line on a service tracking claim from an RX file, then the MSIS identification number reported must start with the '&' (ampersand) symbol.
RULE-6216	If a claim line is a non-denied claim line from an RX file, then the MSIS identification number value reported must be compatible with specified T-MSIS picture format: X(20).

Measure ID	Measure Name
ALL-16-010-10	% of claim lines with TYPE-OF-SERVICE= “086” (RX) linked to an MSIS ID where SEX = “M”
ALL-16-015-15	% of claim lines with XIX-MBESCBES-CATEGORY-OF-SERVICE = “14”, “35”, “42” or “44” (RX) linked to an MSIS ID where SEX = “M”
ALL-16-019-19	% of claims with IHS-SERVICE-IND = “1” not linked to any MSIS ID where AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR = “1”
ALL-16-023-23	% of claims with IHS-SERVICE-IND = “1” (RX) not linked to any MSIS ID where RACE = “003” (American Indian or Alaskan Native)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP022	CIP.002.022	MSIS-IDENTIFICATION-NUM	CIP00002	CLAIM-HEADER-RECORD-IP
CIP234	CIP.003.234	MSIS-IDENTIFICATION-NUM	CIP00003	CLAIM-LINE-RECORD-IP
CLT022	CLT.002.022	MSIS-IDENTIFICATION-NUM	CLT00002	CLAIM-HEADER-RECORD-LT
CLT187	CLT.003.187	MSIS-IDENTIFICATION-NUM	CLT00003	CLAIM-LINE-RECORD-LT
COT022	COT.002.022	MSIS-IDENTIFICATION-NUM	COT00002	CLAIM-HEADER-RECORD-OT
COT157	COT.003.157	MSIS-IDENTIFICATION-NUM	COT00003	CLAIM-LINE-RECORD-OT
CRX022	CRX.002.022	MSIS-IDENTIFICATION-NUM	CRX00002	CLAIM-HEADER-RECORD-RX
ELG019	ELG.002.019	MSIS-IDENTIFICATION-NUM	ELG00002	PRIMARY-DEMOGRAPHICS-ELIGIBILITY
ELG033	ELG.003.033	MSIS-IDENTIFICATION-NUM	ELG00003	VARIABLE-DEMOGRAPHICS-ELIGIBILITY
ELG064	ELG.004.064	MSIS-IDENTIFICATION-NUM	ELG00004	ELIGIBLE-CONTACT-INFORMATION
ELG082	ELG.005.082	MSIS-IDENTIFICATION-NUM	ELG00005	ELIGIBILITY-DETERMINANTS
ELG106	ELG.006.106	MSIS-IDENTIFICATION-NUM	ELG00006	HEALTH-HOME-SPA-PARTICIPATION-INFORMATION
ELG117	ELG.007.117	MSIS-IDENTIFICATION-NUM	ELG00007	HEALTH-HOME-SPA-PROVIDERS
ELG129	ELG.008.129	MSIS-IDENTIFICATION-NUM	ELG00008	HEALTH-HOME-CHRONIC-CONDITIONS
ELG139	ELG.009.139	MSIS-IDENTIFICATION-NUM	ELG00009	LOCK-IN-INFORMATION
ELG149	ELG.010.149	MSIS-IDENTIFICATION-NUM	ELG00010	MFP-INFORMATION
ELG162	ELG.011.162	MSIS-IDENTIFICATION-NUM	ELG00011	STATE-PLAN-OPTION-PARTICIPATION
ELG171	ELG.012.171	MSIS-IDENTIFICATION-NUM	ELG00012	WAIVER-PARTICIPATION
ELG181	ELG.013.181	MSIS-IDENTIFICATION-NUM	ELG00013	LTSS-PARTICIPATION
ELG191	ELG.014.191	MSIS-IDENTIFICATION-NUM	ELG00014	MANAGED-CARE-PARTICIPATION
ELG203	ELG.015.203	MSIS-IDENTIFICATION-NUM	ELG00015	ETHNICITY-INFORMATION
ELG212	ELG.016.212	MSIS-IDENTIFICATION-NUM	ELG00016	RACE-INFORMATION
ELG223	ELG.017.223	MSIS-IDENTIFICATION-NUM	ELG00017	DISABILITY-INFORMATION
ELG232	ELG.018.232	MSIS-IDENTIFICATION-NUM	ELG00018	1115A-DEMONSTRATION-INFORMATION
ELG241	ELG.020.241	MSIS-IDENTIFICATION-NUM	ELG00020	HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME
ELG251	ELG.021.251	MSIS-IDENTIFICATION-NUM	ELG00021	ENROLLMENT-TIME-SPAN-SEGMENT
ELG260	ELG.022.260	MSIS-IDENTIFICATION-NUM	ELG00022	ELG-IDENTIFIERS
TPL019	TPL.002.019	MSIS-IDENTIFICATION-NUM	TPL00002	TPL-MEDICAID-ELIGIBLE-PERSON-MAIN
TPL032	TPL.003.032	MSIS-IDENTIFICATION-NUM	TPL00003	TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO
TPL066	TPL.005.066	MSIS-IDENTIFICATION-NUM	TPL00005	TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CRX.003.111	UPDATE	Coding requirement	1. Mandatory2. Value must be 20 characters or less3. When TYPE-OF-CLAIM = 4, D or X (lump sum payment), value must begin with an '&'	1. Mandatory2. Value must be 20 characters or less3. When TYPE-OF-CLAIM is in [4,D,X] (lump sum payment), value must begin with an "&"
07/13/2023	3.10.0	CRX.003.111	UPDATE	Coding requirement	1. Mandatory2. For SSN States (i.e. SSN Indicator = 1), value must be equal to eligible individual's SSN3. For Non-SSN States (i.e. SSN Indicator = 0), value must not be equal to eligible individual's SSN4. Value must be 20 characters or less5. When TYPE-OF-CLAIM = 4, D or X (lump sum payment), value must begin with an '&'	1. Mandatory2. Value must be 20 characters or less3. When TYPE-OF-CLAIM = 4, D or X (lump sum payment), value must begin with an '&'
07/14/2023	3.10.0	CRX111	UPDATE	Data Dictionary	DE No\|DE Name\|Coding Requirement\| CRX111\|MSIS-IDENTIFICATION-NUM\|For SSN States (i.e. SSN Indicator = 1), value must be equal to eligible individual's SSN\|	DE No\|DE Name\|Coding Requirement\| CRX111\|MSIS-IDENTIFICATION-NUM\|\|
07/14/2023	3.10.0	CRX111	UPDATE	Data Dictionary	DE No\|DE Name\|Coding Requirement\| CRX111\|MSIS-IDENTIFICATION-NUM\|For Non-SSN States (i.e. SSN Indicator = 0), value must not be equal to eligible individual's SSN\|	DE No\|DE Name\|Coding Requirement\| CRX111\|MSIS-IDENTIFICATION-NUM\|\|