TMSIS DD Appendices Crosswalk

T-MSIS Data Dictionary Appendices Crosswalk
RELEASE
DATE

TICKET

6/11/2021

TMSIS18332

DOCUMENT

DE NO

RULE

ACTION

Data Dictionary Appendix A

TOS

8/13/2021

TMSIS18976

Data Dictionary Appendix A

PROCEDURECODE-1 thru
PROCEDURE- N/A
CODE-6

UPDATE

8/13/2021

TMSIS18734

Data Dictionary Appendix A

ELIGIBILITYGROUP

N/A

UPDATE

8/13/2021

TMSIS18734

Data Dictionary Appendix A

MANAGEDCARE-PLANPOP

N/A

UPDATE

N/A

UPDATE

BEFORE
"Medication Assisted Treatment (MAT) services and drugs for
evidenced-based treatment of Opioid Use Disorder (OUD)"
| VVL_ID| VVL_Name| VVL_Field| VVL_Code| VVL_Code_Des
cription| | VVL_Code_Description|
| VVL.186| Procedure Code List| PROCEDURE-CODE-1 thru
PROCEDURE-CODE6| http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnost
icCodes/ICD10.html.|
| VVL_ID| VVL_Name| VVL_Field| VVL_Code| VVL_Code_Des
cription|
| VVL.048| Eligibility Group List| ELIGIBILITYGROUP| 10| Individuals at or below 133% FPL Age 19 through
64| Non-pregnant individuals aged 19 through 64, not otherwise
mandatorily eligible, with income at or below 133% FPL|
| VVL_ID| VVL_Name| VVL_Field| VVL_Code| VVL_Code_Des
cription|
| VVL.048| Managed Care Plan| MANAGED-CARE-PLANPOP| 10| Individuals at or below 133% FPL Age 19 through
64| Non-pregnant individuals aged 19 through 64, not otherwise
mandatorily eligible, with income at or below 133% FPL|
Appendix D #12:
Laboratory and X Ray Services (TOS Code=005, 006, 007, and
008) (See 42 CFR 440.30; 42 CFR § 457.402; 42 CFR §
457.420; 42 CFR § 457.430; 42 CFR § 457.431; 457.440; 42
CFR § 457.450).--These are professional or technical laboratory
and radiological services that are:

7/31/2020

TMSIS13121

Data Dictionary
Appendices (B-Q)

CIP257-0003,
CLT211-0003,
COT186-0003,
CRX134-0003

N/A

UPDATE

•Ordered and provided by or under the direction of a physician
or other licensed practitioner of the healing arts within the scope
of his or her practice as defined by State law or ordered and
billed by a physician but provided by referral laboratory;
•Provided in an office or similar facility other than a hospital
inpatient or outpatient department or clinic; and
•Provided by a laboratory that meets the requirements for
participation in Medicare.
•X-ray services provided by dentists are reported under dental
services.

AFTER
"Medication Assisted Treatment (MAT) services and drugs for
evidenced-based treatment of Opioid Use Disorder (OUD) in
accordance with section 1905(a)(29) of the Social Security Act"
| VVL_ID| VVL_Name| VVL_Field| VVL_Code| VVL_Code_Descrip
tion||VVL_Code_Description|
|VVL.186|Procedure Code List|PROCEDURE-CODE-1 thru
PROCEDURE-CODE6|https://www.cms.gov/Medicare/Coding/ICD10|

N/A

N/A

Appendix D #12:
Laboratory and X Ray Services (TOS Code=005, 006, 007, and
008) (See 42 CFR 440.30; 42 CFR § 457.402; 42 CFR § 457.420;
42 CFR § 457.430; 42 CFR § 457.431; 457.440; 42 CFR §
457.450).--These are professional or technical laboratory and
radiological services that are:

•Ordered and provided by or under the direction of a physician or
other licensed practitioner of the healing arts within the scope of
his or her practice as defined by State law or ordered and billed by
a physician but provided by referral laboratory; and
•Provided by a laboratory that meets the requirements for
participation in Medicare.
•X-ray services provided by dentists are reported under dental
services.

T-MSIS Data Dictionary Appendices Crosswalk
RELEASE
DATE

TICKET

8/13/2021

TMSIS18983

DOCUMENT

Data Dictionary Appendix A

DE NO

TYPE-OFSERVICE

RULE

N/A

ACTION

ADD

BEFORE

N/A

AFTER
| VVL_ID| VVL_Name| VVL_Field| VVL_Code| VVL_Code_Descrip
tion|
|VVL.097|Type of Service (Other Claim) List|TYPE-OFSERVICE| 147| Residential Pediatric Recovery Center (RPRC): A
center or facility that furnishes items and services for which
medical assistance is available under the State plan to infants with
the diagnosis of neonatal abstinence syndrome without any other
significant medical risk factors.
|VVL.076|Type of Service (Long Term Claim) List|TYPE-OFSERVICE| 147| Residential Pediatric Recovery Center (RPRC): A
center or facility that furnishes items and services for which
medical assistance is available under the State plan to infants with
the diagnosis of neonatal abstinence syndrome without any other
significant medical risk factors.
This footnote/paragraph needs to be applied to the Category
*column of *Appendix F of the DD Appendices for
ELIGIBILITY-GROUP *valid values *72, 73, 74, 75.

12/4/2020

TMSIS16331

Data Dictionary
Appendices (B-Q)

ELIGIBILITYGROUP

N/A

UPDATE

N/A

9/11/2020

TMSIS15073

Data Dictionary
Appendices (B-Q)

N/A

N/A

UPDATE

NOTE: CMS’s Revised Financial Management Review Guide
for Family Planning Services describes items and procedures
eligible for the enhanced match as family planning services.

"[1]ACA Medicaid expansion for childless adults (represented in
T-MSIS by ELIGIBILITY-GROUP valid values "72" through
"75") are still technically characterized as mandatory eligibility
groups by Subsection 1902(a)(10)(A) of the Social Security Act
(SSA) despite the U.S. Supreme Court ruling (National Federation
of Independent Business v. Sebelius, 567 U.S. 519 (2012)) which
ruled that states could not be required to offer such coverage.
Therefore, some states may not report any of the Medicaid
expansion groups to T-MSIS if these groups are not applicable to a
particular state."
N/A