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| DE Number | System DE Number | Data Element | Definition | Valid Values |
|---|---|---|---|---|
| ELG200 | ELG.015.200 | RECORD-ID | The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.). | ELG200 Values |
| ELG201 | ELG.015.201 | SUBMITTING-STATE | A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. | ELG201 Values |
| ELG202 | ELG.015.202 | RECORD-NUMBER | A sequential number assigned by the submitter to identify each record segment row in the submission file. The Record Number, in conjunction with the Record Identifier, uniquely identifies a single record within the submission file. | N/A |
| ELG203 | ELG.015.203 | MSIS-IDENTIFICATION-NUM | 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 | N/A |
| ELG204 | ELG.015.204 | ETHNICITY-CODE | A code indicating that the individual's ethnicity is Hispanic, Latino/a, or Spanish ethnicity of a Medicaid/CHIP enrolled individual. Ethnicity Code clarifications: If state has beneficiaries coded in their database as "Hispanic" or "Latino," then code them in T-MSIS as "Hispanic or Latino Unknown" (valid value "5"). DO NOT USE "Another Hispanic, Latino, or Spanish Origin," "Ethnicity Unknown" or "Ethnicity Unspecified." NOTE 1: The "Ethnicity Unspecified" category in T-MSIS (valid value "6") should be used with an individual who explicitly did not provide information or refused to answer a question. | ELG204 Values |
| ELG205 | ELG.015.205 | ETHNICITY-DECLARATION-EFF-DATE | The first calendar day on which all of the other data elements in the same segment were effective. | N/A |
| ELG206 | ELG.015.206 | ETHNICITY-DECLARATION-END-DATE | The last calendar day on which all of the other data elements in the same segment were effective. | N/A |
| ELG207 | ELG.015.207 | STATE-NOTATION | A free text field for the submitting state to enter whatever information it chooses. | N/A |
| ELG271 | ELG.015.271 | ETHNICITY-OTHER | A freeform field to document the ethnicity of the beneficiary when the beneficiary identifies themselves as Another Hispanic, Latino, or Spanish origin (ethnicity code 4). | N/A |
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