ELG.005.094

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

CONCEPTION-TO-BIRTH-IND

Data Element

DE Number

ELG094

System DE Number

ELG.005.094

File Name

File Segment Number

File Segment Name

ELIGIBILITY-DETERMINANTS

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A flag to identify children eligible through the conception to birth option, which is available only through a separate State CHIP Program.
Size	X(1)
FLF Start Position	78
FLF Stop Position	78
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be in Conception to Birth Indicator List (VVL) 2. Value must be 1 character 3. Value must be in [0, 1] or not populated 4. If the value is equal to "1", then the Eligibility Group (ELG.005.087) must equal "64" 5. If the value is equal to "1", then any associated claims must indicate the Program Type = '14' (State Plan CHIP) 6. If the value is equal to "1", then CHIP Code (ELG.003.054) must equal "3" (Individual was not Medicaid Expansion CHIP eligible, but was included in a separate title XXI CHIP Program) 7. Conditional

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

RULE ID	RULE Definition
RULE-2145	If the conception to birth indicator is populated on a eligibility determinants file, then the conception to birth indicator reported must be found in the list of valid values.
RULE-6385	If a segment is an eligibility determinants segment from an ELG file, the conception to birth indicator value reported must be compatible with the specified T-MSIS picture format: X(1).

Measure ID	Measure Name

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

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/16/2023	3.12.0	ELG.005.094	UPDATE	Coding requirement	1. Value must be in Conception to Birth Indicator List (VVL)2. Value must be 1 character3. Value must be in [0, 1] or not populated4. If the value is equal to "1", then the Eligibility Group (ELG.005.087) must equal "64"5. If the value is equal to "1", then any associated claims must indicate the Program Type = '14' (State Plan CHIP)6. If the value is equal to "1", then CHIP Code (ELG.003.054) must equal "3" (Individual was not Medicaid Expansion CHIP eligible, but was included in a separate title XXI CHIP Program)7. Value must be 1 character8. Conditional	1. Value must be in Conception to Birth Indicator List (VVL)2. Value must be 1 character3. Value must be in [0, 1] or not populated4. If the value is equal to "1", then the Eligibility Group (ELG.005.087) must equal "64"5. If the value is equal to "1", then any associated claims must indicate the Program Type = '14' (State Plan CHIP)6. If the value is equal to "1", then CHIP Code (ELG.003.054) must equal "3" (Individual was not Medicaid Expansion CHIP eligible, but was included in a separate title XXI CHIP Program)7. Conditional
12/13/2019	2.3.0	CONCEPTION-TO-BIRTH-IND (ELG094)	UPDATE	Data Dictionary	The CHIP-CODE must equal “3” (Individual was not Medicaid-Expansion CHIP eligible, but was included in a separate title XXI CHIP program) or “4” (Individual was both Medicaid eligible and Separate CHIP eligible.)	The CHIP-CODE must equal “3” (Individual was not Medicaid-Expansion CHIP eligible, but was included in a separate title XXI CHIP program).