Master Data Element Dictionary, version 20240608: NCMMIS 5501 - 6000

Master Data Element Dictionary, version 20240608: NCMMIS 5501 - 6000

PA Type Codes Accepting Attachments

NCMMIS Number: 5501

Description: This is a subset of all the PA Type codes (DE#4601). It includes only those PA types that may have attachments.

Data Type: CHARACTER

Size: X(3)

Functional Area Owner: Prior Authorization

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

A04

A04

DME

DURABLE MEDICAL EQUIPMENT

A05

A05

DENTAL

DENTAL

A06

A06

ORTHODONTI

ORTHODONTIC

A08

A08

HEARING AI

HEARING AID

A10

A10

HOSPICE

HOSPICE

A11

A11

LTC - NF

LONG TERM CARE - NURSING FACILITY

A12

A12

LTC - SH

LONG TERM CARE - SPECIALTY HOSP

A16

A16

MEDICAL

MEDICAL

A17

A17

OUT OF STA

OUT OF STATE

A18

A18

OOS SURGER

OUT OF STATE SURGERY

A19

A19

SURGERY

SURGERY

A21

A21

PDN

PRIVATE DUTY NURSING

A22

A22

TRANSPLANT

TRANSPLANTS

A23

A23

EXC. TO LE

EXCEPTION TO LEGISLATIVE LIMITS

A24

A24

MPW

MEDICAID FOR PREGNANT WOMEN

A31

A31

LTC-CAP

LONG TERM CARE - CAP

A35

A35

OPTICAL

OPTICAL

A36

A36

VISUAL AID

VISUAL AID

A37

A37

REFRACTION

REFRACTION PRIOR APPROVAL

A39

A39

OOS - AMBU

OUT OF STATE AMBULANCE

A47

A47

THER. LEAV

THERAPEUTIC LEAVE

A60

A60

AMBULANCE

AMBULANCE

A61

A61

HOME HLTH

HOME HEALTH

A80

A80

AUD IMPL

AUDITORY IMPLANTS

A99

A99

PHARMACY

PHARMACY

P21

P21

APPLI DME

APPLIANCES/DME

P22

P22

AUDIOLOGY

AUDIOLOGY

P23

P23

CCE

CASE CONSULTATION AND EDUCATION

P24

P24

CBRS

COMMUNITY BASED REHABILITATIVE SERVICES

P25

P25

DEV. EVAL.

DEVELOPMENTAL EVALUATIONS

P26

P26

ADAP FORM

ADAP FORMULARYDRUGS

P27

P27

FAM COUNSE

FAMILY COUNSELING AND THERAPY

P28

P28

FORMULA

FORMULA

P29

P29

INPAT. HOS

INPATIENT HOSPITAL ADMISSION

P30

P30

HOME NURSI

HOME NURSING CARE

P31

P31

NUTRITION

NUTRITION SERVICES

P32

P32

OP HOSP V

OUTPATIENT HOSPITAL VISITS

P33

P33

PHYS. OFFI

PHYSICIANS OFFICE VISIT

P34

P34

PSYCHOLOGI

PSYCHOLOGICAL SERVICES

P35

P35

SW SERVICE

SOCIAL WORK SERVICES

P36

P36

OT SERVICE

OCCUPATIONAL THERAPY SERVICES

P37

P37

SPEECH/LAN

SPEECH/LANGUAGE SERVICES

P38

P38

SUPPLIES

SUPPLIES

P39

P39

TARGETED C

TARGETED CASE MANAGEMENT

P40

P40

CHEMOTHERA

CHEMOTHERAPY

P41

P41

ORTHODONTI

ORTHODONTIA

P42

P42

OUTP. DIAL

OUTPATIENT DIALYSIS

P43

P43

RADIATION

RADIATION TREATMENT

P44

P44

RESIDENTIA

RESIDENTIAL CARE

P45

P45

OP HOSP S

OUTPATIENT HOSPITAL SURGERY

P46

P46

ER VISITS

EMERGENCY ROOM VISITS

P47

P47

PHYS. THER

PHYSICAL THERAPY

P48

P48

DENT VISIT

DENTAL OFFICE VISITS

P49

P49

HIT

HOME INFUSION THERAPY

P50

P50

SC FORMUL

SICKLE CELL FORMULARY

P51

P51

ERYTHROPO

ERYTHROPOIETIN

P52

P52

DPH DRUG

DPH DRUGS - OTHER

 

Last Update: 11/20/2023 8:48:57 AM

 

Antifungal Treatment Contraindication Indicator

NCMMIS Number: 5502

Description: Antifungal Treatment Contraindication Indicator indicates if the recipient is unable to receive treatment with topical antifungal therapy and Diflucan.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 5/18/2010 4:13:58 PM

 

Antifungal Other Condition

NCMMIS Number: 5503

Description: Antifungal Other Condition describes the other condition.

Data Type: CHARACTER

Size: X(30)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 5/18/2010 4:13:59 PM

 

Orencia More Than One Biologic RA Agent Indicator

NCMMIS Number: 5504

Description: Orencia More Than One Biologic RA Agent Indicator indicates if the recipient will be receiving more than one biologic rheumatoid arthritis agent at the same time.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 5/17/2010 4:06:42 PM

 

Oencia Moderate to Severe Rheumatoid Arthritis Indicator

NCMMIS Number: 5505

Description: Orencia Moderate to Severe Rheumatoid Arthritis Indicator indicates if the recipient has this condition.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 5/17/2010 4:06:44 PM

 

Orencia Moderate to Severe JIA/JRA Indicator

NCMMIS Number: 5506

Description: Orencia Moderate to Severe JIA/JRA Indicator indicates if the recipient has Juevenile Idiopathic Arthritis (JIA) or Juvenile Rheumatoid Arthritis (JRA).

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 5/17/2010 4:06:47 PM

 

Simponi More Than One Biologic RA Agent Indicator

NCMMIS Number: 5507

Description: Simponi More Than One Biologic RA Agent Indicator indicates if the recipient will be receiving more than one biologic rheumatoid arthritis agent at the same time.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

Last Update: 5/17/2010 4:06:56 PM

 

Simponi TB Evaluation Code

NCMMIS Number: 5508

Description: Simponi TB Evaluation Code indicates if the recipient will be evaluated and screened for the presence of latent TB infection.

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Prior Authorization

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

N

N

NO

NO

W

W

NOTWARR

NOT WARRANTED

Y

Y

YES

YES

 

Last Update: 11/20/2023 8:42:38 AM