CRX.003.128

Definition	The amount paid by Medicaid/CHIP on this claim toward the recipient's Medicare coinsurance at the claim detail level. If the Medicare coinsurance amount can be identified separately from Medicare deductible payments, code that amount in this field. If Medicare coinsurance and deductible payments cannot be separated, populate the Medicare Deductible Amount.
Size	S9(11)V99
FLF Start Position	264
FLF Stop Position	276
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. If associated Medicare Combined Deductible Indicator is "1", then value must not be populated (or must be 99998) 4. Value must not be populated if Medicare Deductible Amount is not populated 5. Conditional

RULE ID	RULE Definition
RULE-1932	If a claim is a non-denied claim from an RX file, then the medicare coinsurance amount value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(11)V99.

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/12/2024	3.29.0	CRX.003.128	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. If associated Medicare Combined Deductible Indicator is '1', then value must not be populated (or must be 99998)4. Value must not be populated if Medicare Deductible Amount is not populated5. Conditional	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. If associated Medicare Combined Deductible Indicator is "1", then value must not be populated (or must be 99998)4. Value must not be populated if Medicare Deductible Amount is not populated5. Conditional
06/24/2022	3.0.0	MEDICARE-COINS-AMT	UPDATE	Data Dictionary	DE NO\|DATA ELEMENT NAME\|DEFINITION\|CODING REQUIREMENT\| CRX128\|MEDICARE-COINS-AMT\|The amount paid by Medicaid/CHIP on this claim toward the recipient's Medicare coinsurance at the claim detail level. If the Medicare coinsurance amount can be identified separately from Medicare deductible payments, code that amount in this field. If Medicare coinsurance and deductible payments cannot be separated, populate the MEDICARE-DEDUCTIBLE-AMT. See US Dollar Amount (DT)\| 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.(payments can't be separated) value 99998 is an exception to the US Dollar Amount requirements 4.(N) conditional	DE NO\|DATA ELEMENT NAME\|DEFINITION\|CODING REQUIREMENT\| CRX128\|MEDICARE-COINS-AMT\|The amount paid by Medicaid/CHIP on this claim toward the recipient's Medicare coinsurance at the claim detail level. If the Medicare coinsurance amount can be identified separately from Medicare deductible payments, code that amount in this field. If Medicare coinsurance and deductible payments cannot be separated, populate the Medicare Deductible Amount.\| 1. Value must be between -99999999999.99 and 99999999999.99 2. if associated Medicare Combined Deductible Indicator is '1', then value must not be populated (or must be 99998) 3. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 4. Value must not be populated if Medicare Deductible Amount is not populated 5. Conditional

MEDICARE-COINS-AMT