ELG.004.070

ELIGIBLE-STATE

Data Element

DE Number

ELG070

System DE Number

ELG.004.070

File Name

ELG - ELIGIBLE

File Segment Number

ELG00004

File Segment Name

ELIGIBLE-CONTACT-INFORMATION

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The ANSI state numeric code for the U.S. state, Territory, or the District of Columbia code for where the individual eligible to receive healthcare services resides. (The state for the type of address indicated in Address Type.)
Size	X(2)
FLF Start Position	252
FLF Stop Position	253
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in State Code List (VVL) 2. Value must be 2 characters 3. Mandatory

This data element's valid value code set is maintained by a Code Set Maintenance Organization (CSMO), the official licensing organization for specific valid value code sets. The CSMO is the system of record for those specific valid value code sets. While T-MSIS endeavors to be in-sync with CMSO's updates, minor delays may occur but that shouldn't block T-MSIS data submissions using the CSMO's latest version.

State Code List

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

RULE ID	RULE Definition
RULE-2096	If the eligible state is populated on a eligible contact information file, then the eligible state reported must be found in the list of valid values.
RULE-2098	If eligible county code is populated on an eligible contact information segment from an ELG file, then the eligible county code value reported must be in the list of valid county values for the state.
RULE-7072	If a segment is an eligible contact information segment, then the eligible state value reported must be compatible with the specified T-MSIS picture format: X(2).
RULE-7530	If the MSIS ID is populated on a eligible contact information segment from an ELG file, and the address type is '01' for primary home address, and eligible state is equal to the submitting state, then the eligible county code and eligible zip code are in the submitting state.
RULE-7532	If the MSIS ID is populated on a eligible contact information segment from an ELG file, then the eligible county code is in the eligible state.
RULE-7980	If the MSIS ID is populated on a eligible contact information segment from an ELG file, then the eligible eligible zip code are in the eligible state.

Measure ID	Measure Name
EL-1-023-23	% of MSIS IDs in which the primary home address county code, zip code, or state is not in-state
EL-1-024-30	% of MSIS IDs in which a non-primary home address county code, zip code, or state is not in-state and not missing
EL-1-025-31	% of MSIS IDs where county code or zip code does not align with address state and is not missing
EL-1-024-24	% of MSIS IDs in which a non-primary home address county code, zip code, or state is not in-state
EL-1-025-28	% of MSIS IDs where county code or zip code does not align with address state
RULE-7532	% of record segments where county code does not align with address state and is not missing
RULE-7980	% of record segments where zip code does not align with address state and is not missing

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name