Master Data Element Dictionary, version 20240608: NCMMIS 1501 - 2000
CMS Age Group Code
NCMMIS Number: 1501
Description: CMS Age Group Code specifies an age range breakout group designated by the Center for Medicare & Medicaid Services (CMS) for the 2082 report.
Data Type: CHARACTER
Size: X(2)
Functional Area Owner: MAR
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
10 | 10 | < 1 YEAR | < 1 YEAR OLD |
11 | 11 | AGE 1 - 5 | AGE 1 - 5 YEARS |
12 | 12 | AGE 6 - 9 | AGE 6 - 9 YEARS |
13 | 13 | AGE 10 | AGE 10 YEARS |
14 | 14 | AGE 11-14 | AGE 11 - 14 YEARS |
15 | 15 | AGE 15-20 | AGE 15 - 20 YEARS |
20 | 20 | AGE 21 | AGE 21 YEARS |
21 | 21 | AGE 22 | AGE 22 YEARS |
22 | 22 | AGE 23-44 | AGE 23 - 44 YEARS |
23 | 23 | AGE 45-64 | AGE 45 - 64 YEARS |
30 | 30 | AGE 65-74 | AGE 65 - 74 YEARS |
31 | 31 | AGE 75-84 | AGE 75 - 84 YEARS |
32 | 32 | AGE 85 + | AGE 85 + YEARS |
99 | 99 | UNKNOWN | YEARS UNKNOWN |
Last Update: 9/29/2011 7:37:30 AM
CMS Exception Code
NCMMIS Number: 1502
Description: CMS Exception Code specifies when a client's age is inconsistent with a service type or aid category.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: MAR
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
A | A | AGECAT | AID CATEGORY / AGE EXCEPTION |
D | D | DETCAT | DETAIL CATEGORY OF SERVICE / AGE EXCEPTION |
E | E | ESPDT | ESPDT SERVICE / AGE EXCEPTION |
F | F | FAMILYPLAN | FAMILY PLANNING SERVICE / AGE EXCEPTION |
H | H | INPATIENT | INPATIENT PSYCHIATRIC SERVICE / AGE EXCEPTION |
Last Update: 9/29/2011 7:37:35 AM
CMS 2082 Crosswalk Family Planning Code
NCMMIS Number: 1503
Description: CMS 2082 Crosswalk Family Planning Code specifies whether a crosswalk entry is family planning or sterilization related for generation of the Center for Medicare & Medicaid Services (CMS) 2082 report.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: MAR
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
F | F | FAMILYPLAN | FAMILY PLANNING |
S | S | STERILIZTN | STERILIZATION |
SPACE | SPACE | ALL OTHER | ALL OTHER |
Last Update: 9/29/2011 7:37:37 AM
Claim Report Criteria Text
NCMMIS Number: 1504
Description: Claim Report Criteria Text is the selection criteria used to produce the requested Drug Utilization Review (DUR) report.
Data Type: CHARACTER
Size: X(8)
Functional Area Owner: Claims
Valid Values:
Last Update: 12/16/2009 4:31:57 PM
Provider Address City
NCMMIS Number: 1506
Description: Provider Address City is the city in which the provider does business or to which correspondence should be sent.
Data Type: CHARACTER
Size: X(25)
Functional Area Owner: Provider
Valid Values:
Last Update: 12/16/2009 4:30:12 PM
Provider Address Line 1
NCMMIS Number: 1508
Description: Provider Address Line 1 is the street address for a provider
Data Type: CHARACTER
Size: X(40)
Functional Area Owner: Provider
Valid Values:
Last Update: 4/18/2016 10:39:21 AM
MAR Report Literal Text
NCMMIS Number: 1509
Description: MAR Report Literal Text is the report line or column literal value associated with a report key (DE 1812).
Data Type: CHARACTER
Size: X(64)
Functional Area Owner: MAR
Valid Values:
Last Update: 9/29/2011 7:38:43 AM
Provider Affiliation End Date
NCMMIS Number: 1515
Description: End date of provider affiliation
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 4/23/2010 10:48:27 AM
MAR Involvement Indicator Code
NCMMIS Number: 1516
Description: MAR Involvement Indicator Code indicates whether or not a claim has Medicare or other third party involvement.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: MAR
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
1 | 1 | NONE | NO THIRD PARTY INVOLVEMENT |
2 | 2 | MEDICARE | MEDICARE INVOLVED |
3 | 3 | OTHER | OTHER THIRD PARTY INVOLVED |
Last Update: 9/29/2011 7:34:08 AM
MAR Provider Payment Rank Code
NCMMIS Number: 1517
Description: MAR Provider Payment Rank Code is the numeric ranking of a provider based on the total payment amount received during a reporting period.
Data Type: CHARACTER
Size: X(5)
Functional Area Owner: MAR
Valid Values:
Last Update: 9/29/2011 7:38:30 AM
Provider Application Date
NCMMIS Number: 1518
Description: Provider Application Date is the Date on a provider's initial enrollment package or the date when a provider first start filling his application form thru on-line but may not have submitted at that point
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 5/6/2010 2:03:40 PM
Provider Bank Routing Number
NCMMIS Number: 1520
Description: Provider Bank Routing Number identifies the bank that administers the provider's bank account. The American Banking Association assigns this unique number to every bank.
Data Type: CHARACTER
Size: X(10)
Functional Area Owner: Financial
Valid Values:
Last Update: 3/12/2021 1:58:06 PM
PA Submission Date
NCMMIS Number: 1521
Description: Prior Authorization/Approval (PA) Submit Date is the date on which a PA was entered into NCMMIS
Data Type: DATE
Size: X(10)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 3/16/2012 11:24:44 AM
Inlier Amount
NCMMIS Number: 1525
Description: Inlier Amount is the dollar amount to be paid by Medicaid for services received by a patient, during the inlier period (the portion of a hospital stay where the length of stay is below the high trimpoint).
Data Type: CURRENCY
Size: S9(9)V99
Functional Area Owner: Claims
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
ZERO | ZERO | DEFAULT | DEFAULT |
Last Update: 3/15/2022 11:50:26 AM
Outlier Amount
NCMMIS Number: 1526
Description: Outlier Amount is the dollar amount to be paid by Medicaid for services received by a patient, during the outlier period (the portion of a hospital stay where the length of stay is greater than the high trimpoint).
Data Type: CURRENCY
Size: S9(9)V99
Functional Area Owner: Claims
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
ZERO | ZERO | DEFAULT | DEFAULT |
Last Update: 3/15/2022 11:50:27 AM
CLIA Certification End Date
NCMMIS Number: 1527
Description: CLIA Certification End Date is the last day of a provider's Clinical Laboratory Improvement Amendments (CLIA) certification.
Data Type: DATE
Size: X(10)
Functional Area Owner: Reference
Valid Values:
Last Update: 12/16/2009 4:29:44 PM
CLIA Certification Begin Date
NCMMIS Number: 1528
Description: CLIA Certification Begin Date is the first day of a provider's Clinical Laboratory Improvement Amendments (CLIA) certification.
Data Type: DATE
Size: X(10)
Functional Area Owner: Reference
Valid Values:
Last Update: 12/16/2009 4:29:44 PM
CLIA Laboratory Class Code
NCMMIS Number: 1529
Description: CLIA Laboratory Class Code specifies groups of laboratory procedures, to ensure that providers are qualified to perform a service within a Clinical Laboratory Improvement Amendments (CLIA) certification date range.
Data Type: CHARACTER
Size: X(3)
Functional Area Owner: Reference
Valid Values:
From Value | Thru Value | Short Description | Long Description |
|---|---|---|---|
010 | 010 | 010 | HISTOCOMPATIBILITY TESTING |
100 | 100 | 100 | MICROBIOLOGY |
110 | 110 | 110 | BACTERIOLOGY |
115 | 115 | 115 | MYCOBACTERIOLOGY |
120 | 120 | 120 | MYCOLOGY |
130 | 130 | 130 | PARASITOLOGY |
140 | 140 | 140 | VIROLOGY |
150 | 150 | 150 | OTHER MICROBIOLOGY |
200 | 200 | 200 | DIAGNOSTIC IMMUNOLOGY |