Valid Values for VaMMIS Data Fields

The Valid Values are organized in alphabetical order. Select a letter of the alphabet to go to Valid Values starting with that letter, then click the link to see the Valid Values for that field.

A B C D E F I L M P R S T

Data provided by the Virginia Department of Social Services.

field	menu/screen
A/P	TPL Resource
Action	Spend Down Maintenance
ASN CD	HMO/PCP Assignment
ASNMT Data	Managed Care Assignment
BNFT PGM	Level of Care top of page
Case Type	MICC Information
CH CD	Managed Care Assignment
CHG SRC	Enrollee Benefits Level of Care
Citizenship STAT	Enrollee Demographics
CMM Level	CMM Restriction Period Data Managed Care Assignment
CMM ST Code	Managed Care Assignment
CMM Type	CMM Restriction Period Data
Code	MICC Information
COV	TPL Resource top of page
Data	MICC Information
Disability Code	Enrollee Demographics
End RSN	CMM Restriction Period Data
EXC IND	Enrollee Demographics
EXCP	Managed Care Assignment
EXT RSN	Enrollee Benefits Eligibility Data
FIPS End RSN	Case Data
ID Request Reissue Reason	Enrollment Menu top of page
ISS-RSN	Enrollee Demographics
LOC	Level of Care
Marital STAT	Enrollee Demographics
POL Type	TPL Resource
PREASN RSN	HMO/PCP Assignment Managed Care Assignment
PREM Type	TPL Resource
PRIM LANG	Enrollee Demographics
Race	Enrollee Demographics
REIN RSN	Eligibility Data Enrollee Benefits
REL	Case Data
REL	TPL Resource top of page
REL to Case Head	Enrollee Demographics
Relationship	Case Data
Restriction End RSN	Managed Care Assignment
Risk Level	MICC Information
RPT	MICC Information
Sex	Enrollee Demographics Enrollment Menu Managed Care Assignment Search Results: Select Spend Down Maintenance
Show	Managed Care Menu
Source	TPL Resource top of page
SSN STAT	Enrollee Demographics
STAT	Enrollee Benefits Search Results: Select
Status	TPL Resource
Status Code	CMM Restriction Period Data
Student/HOSP Child?	Enrollee Demographics
SUB Program	Managed Care Assignment
SUF	Search Results: Select Spend Down Search
Suffix	Assessment Maintenance Menu Enrollment Menu Level of Care
SUFX	Case Data Enrollee Demographics Spend Down Maintenance
Type	Managed Care Assignment
Type	TPL Absent Parent
Type Coverage	TPL Resource

 

A/P - TPL Resource Screen
D	Dual
I	Insured
U	Uninsured
blank	Not Applicable

 

 

 

 

top of page

Action - Spend Down Maintenance Screen
A	Add
U	Update
I	Inquiry

 

 

 

top of page

ASN CD - HMO/PCP Assignment Screen
01	Enrollee selected PCP
02	PCP automatically selected/assigned
03	PCP submitted enrollee selection
04	Automatic mass Re-Assignment
05	DMAS selected/ assigned
07	Unknown

 

 

 

 

 

top of page

ASNMT Data - Managed Care Assignment Screen
01	Enrollee selected PCP
02	PCP automatically selected/ assigned
03	PCP submitted enrollee selection
04	Automatic mass Re-Assignment
05	DMAS selected/ assigned
07	Unknown

 

 

 

 

 

top of page

BNFT PGM - Level of Care Screen
01	Medicaid
02	TDO (Temporary Detention Order)
03	SLH (State and Local Hospitals)
04	HIV Premium Payments
05	Regular Assisted Living
06	HIDP (Health Insurance Demonstration Program)
07	FAMIS
08	Assessments

 

 

 

 

 

 

top of page

Case Type - MICC Information Screen
blank	Undetermined
E	Enrolled in MICC
P	Enrollment is pending
U	Unknown (Conversion)

 

 

 

 

top of page

CH CD - Managed Care Assignment Screen
00	No Change Source
01	Provider
02	Recipient
03	Utilization Review Analyst
04	Other MSS Staff
05	Department of Social Services
06	DMHMRSAS
07	DMAS - Managed Care
08	DMAS - CMM
86	Vent
87	AIDS
88	System Generated (manual entry not allowed)
89	Complex
91	TBI
92	Rehab
99	Unknown
CD	Converted Data (used only during conversion)
DF	Default benefit which may not be modified manually

 

 

 

 

 

 

 

 

 

 

 

 

top of page

CHG SRC - Enrollee Benefits Screen - Level of Care Screen
00	No Change Source
01	Provider
02	Recipient
03	Utilization Review Analyst
04	Other MSS Staff
05	Department of Social Services
06	DMHMRSAS
07	DMAS - Managed Care
08	DMAS - CMM
86	Vent
87	AIDS
88	System-generated (manual entry not allowed)
89	Complex
91	TBI
92	Rehab
99	Unknown
CD	Converted Data (used only during conversion)
DF	Default benefit which may not be modified manually.

 

 

 

 

 

 

 

 

 

 

 

top of page

Citizenship STAT - Enrollee Demographics Screen
A	Undocumented/ Illegal Alien or Legal Alien eligible only for emergency services
C	U.S. Citizen
D	Undocumented/ Illegal Alien or Legal Alien eligible only for dialysis services
E	Entrant
I	Grandfathered Alien
N	Naturalized U.S. Citizen
P	Full-benefited Qualified Alien
R	Refugee
V	Visitor, Temporary Visa

 

 

 

 

 

 

 

 

top of page

CMM Level - CMM Restriction Period Data Screen - Managed Care Assignment Screen
001	Physician and Pharmacy
002	Pharmacy and Transportation
003	Physician and Transportation
004	Physician Only
005	Pharmacy Only
006	Transportation Only
007	Physician, Pharmacy, and Transportation

 

 

 

 

 

 

top of page

CMM ST Code - Managed Care Assignment Screen
A	Active
P	Pending - when an enrollee appeals the decision by DMAS to restrict them
V	Void

 

 

 

 

top of page

CMM Type - CMM Restriction Period Data Screen
C18	Continue 18 months
C36	Continue 36 months
I18	Initial 18 months
I36	Initial 36 months
R24	Reenroll 24 months
R36	Reenroll 36 months

 

 

 

 

 

top of page

Code - MICC Information Screen
01	Add
03	Change
04	Delete
05	Cancel
06	Reinstate
07	Reject

 

 

 

 

 

top of page

COV - TPL Resource Screen
A	Medicare Part A
B	Medicare Part B
C	Cancer
D	Dental
E	Not assigned
F	Home Health/ Personal Care
G	Mental Health
H	Hospitalization
I	Indemnity/ Accident
J	Dependent Pregnancy
K	Medicare Extended
L	Managed Care (HMO/PPO)
M	Major/ Medical-Comprehensive
N	Intermediate Care
O	Optical/Vision
P	Physician
Q	Chiropractor
R	Pharmacy
S	Skilled Nursing
T	Transportation
U	Uninsured Absent Parent
V	Rehabilitation/ Physical Medicine
W	Worker's Compensation
X	Preventive Care
Y	Medicare Part A-HMO
Z	Medicare Part B- HMO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

top of page

Data - MICC Information Screen
C	Case Management
M	Care Coordination
O	Outcome
R	Risk

 

 

 

 

top of page

Disability Code - Enrollee Demographics Screen
100	Permanent
200	Temporary, Long Term
300	Temporary, Less than 6 months

 

 

 

top of page

End RSN - CMM Restriction Period Data Screen
01	Inactive Due Appeal
02	Inactive Due Mandatory Managed Care
03	Released from CMM - No Abuse
04	Released from CMM - Not eligible
05	Data Entry Error
06	Inactive - Enter Long Term Care
07	Continued Lock-in
08	Change of CMM Level
99	Conversion

 

 

 

 

 

 

top of page

EXC IND - Enrollee Demographics Screen EXCP - Managed Care Assignment Screen LOC - Level of Care Screen
1	ICF
2	SNF
4	CMM Physician
5	CMM Pharmacy
6	CMM Transportation
7	Out of State
9	Personal Care (SMF, ICF, Adult Day, Respite Care)
A	Technology Assisted Waiver
E	AIDS Waiver
F	Regular Assisted Living
J	Intensive Assisted Living
L	Long Stay Hospital
Q	CDPAS Waiver
R	IFDDS Waiver
Y	MR Waiver

 

 

 

 

 

 

 

 

 

 

 

top of page

EXT RSN - Enrollee Benefits Screen - Eligibility Data Screen
004	Recipient coverage extended, welfare reform twelve (12) month transition.
005	Recipient coverage extended, four (4) month extention due to child support.
006	Recipient coverage extended, employment twelve (12) month extention.
007	Recipient coverage due to diversionary assistance, lump sum receipt.

 

 

 

 

 

top of page

FIPS End RSN - Case Data Screen
001	Moved (default)
002	Administrative reassignment
003	Institutionalized

 

 

 

top of page

ID Request Reissue Reason - Enrollment Menu
C	Change of Demographic Information (only system-generated)
D	Destroyed
I	Initial Card
L	Lost
S	Stolen

 

 

 

 

 

top of page

ISS-RSN - Enrollee Demographics Screen
C	Change of Demographic Information (only system entered)
D	Destroyed
I	Initial Card
L	Lost
S	Stolen

 

 

 

 

 

top of page

Marital STAT - Enrollee Demographics Screen
D	Divorced
I	Single
M	Married
S	Separated
U	Unreported
W	Widowed

 

 

 

 

 

top of page

POL Type - TPL Resource Screen
A	Automobile
B	Burial
C	Casualty
D	Disability
E	Homeowner
F	CHAMPUS
G	Absent Parent
H	Health
I	Trusts
J	HIPP
K	HIV
L	Life
M	Medicare
N	Worker's Compensation
O	Other

 

 

 

 

 

 

 

 

 

top of page

PREASN RSN - HMO/PCP Assignment Screen - Managed Care Assignment Screen
' '	Currently Not pre-assigned/ assigned
01	Currently assigned to a CMM Provider
04	Exempt from managed care by DMAS
05	Enrollee currently pre-assigned
06	60 day re-enrollment
07	Enrollee not in Medicaid
08	Department exempt special
09	Enrollee not in a managed care region/locality
10	Enrollee currently assigned to Managed Care
11	Nursing home or Waiver
12	Invalid managed care Aid Category
13	Exempt due to hospital related prior authorization(s)
14	Enrollee has TPL
15	Default Benefit Package not valid for Managed Care
CM	Enrollee is exempt from managed care because of CMM enrollment
X	Bypass locality edits when validating pre-assignment or assignment

 

 

 

 

 

 

 

 

 

 

top of page

PREM Type - TPL Resource Screen
A	ADAP
D	HIDP
H	HIPP
R	HIV
blank	Not Applicable

 

 

 

 

top of page

PRIM LANG - Enrollee Demographics Screen
A	Arabic
C	Chinese
E	English
F	French
G	German
J	Japanese
S	Spanish

 

 

 

 

 

top of page

Race - Enrollee Demographics Screen
1	White
2	Black/African American
3	American Indian/ Alaskan Native
4	Oriental/Asian
5	Spanish American/ Hispanic
6	Native Hawaiian or Other Pacific Islander
9	Other

 

 

 

 

 

top of page

REIN RSN - Eligibility Data Screen - Enrollee Benefits Screen
001	Recipient coverage reopened due to timely appeal
002	Recipient coverage reopened due to appeal decision.
003	Recipient coverage reopened, canceled in error.

 

 

 

 

top of page

REL, Relationship - Case Data Screen REL to Case Head - Enrollee Demographics Screen
00	Self
01	Spouse
02	Child
03	Grandchild
04	Stepchild
05	Parent
06	Grandparent
07	Stepparent
08	Brother/Sister (sibling)
09	Step Sibling
10	Sibling In-law
11	Aunt/Uncle
12	Niece/Nephew
13	First Cousin
14	First Cousin, Once Removed
15	Other Relative
16	Foster Child
17	Alien Sponsor
18	Other, Not Related
99	Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

top of page

REL - TPL Resource Screen
A	Self
C	Child
D	Widow(er)
F	Unremarried Widow(er)
G	Unmarried Widow(er)
I	Parent-In-Law
M	Step-Parent-In-Law
P	Parent
S	Spouse
T	Unremarried Former Spouse
U	Step-Parent
V	Step-Child
W	Ward
X	Other

 

 

 

 

 

 

 

 

 

top of page

Restriction End RSN - Managed Care Assignment Screen
01	Inactive Due Appeal
02	Inactive Due Mandatory Managed Care
03	Released from CMM-No Abuse
04	Released from CMM-Not eligible
05	Data Entry Error
06	Inactive - Enter Long Term Care
07	Continued Lock-in
08	Change of CMM Level
99	Conversion

 

 

 

 

 

 

 

top of page

Risk Level - MICC Information Screen
0	Low Risk
1	Medium Risk
2	High Risk
blank	Undetermined
U	Unknown (Conversion)

 

 

 

 

 

top of page

RPT - MICC Information Screen
blank	No Entry, default
N	No
S	System-generated ending, Outcome Report is not required.
U	Unknown (Conversion)
Y	Yes

 

 

 

 

 

top of page

Sex - Enrollee Demographics Screen - Enrollment Menu - Managed Care Assignment Screen - Search Results: Select Screen - Spend Down Mainteance Screen
F	Female
M	Male
U	Unknown

 

 

 

 

top of page

Show - Managed Care Menu SUB Program - Managed Care Assignment
01	Only CMM assignments (segments) with an exception indicator of 4, 5, or 6 are to be listed.
02	Only Medallion managed care pre-assignment/ assignments are listed.
03	Only Medallion II pre-assignments/ assignments (segments) are to be listed.
04	Only Options assignments are listed.

 

 

 

 

 

top of page

Source - TPL Resource Screen
A	Child Support
B	Medicare-Buy-In
C	Carrier
D	DMAS
E	DEERS
O	Other
P	Provider
R	Recipient
S	DSS
T	TPL Contractor

 

 

 

 

 

 

 

top of page

SSN STAT - Enrollee Demographics Screen
1	SSN not on SSA Master
2	Name and DOB match, sex does not match
3	Name and sex match, DOB does not match
4	Name matches, DOB and sex do not match
5	Name does not match, DOB and sex were not checked
7	Name, DOB, and sex match, SSN is correct
E	SSN has not been verified and must be sent to SSA
blank	SSN has not been verified and must be sent to SSA

 

 

 

 

 

 

top of page

STAT - Enrollee Benefits Screen - Search Results: Select Screen
A	Active
C	Canceled or Closed
V	Void

 

 

 

 

top of page

Status - TPL Resource Screen
A	Active
I	Inactive
P	Potential
S	Suspect
U	Uninsured Absent Parent

 

 

 

 

 

top of page

Status Code - CMM Restriction Period Data Screen
A	Active
P	Pending
V	Void

 

 

 

top of page

Student/HOSP Child? - Enrollee Demographics Screen
HC	Hospitalized Child
ST	Student
UM	Unaccompanied Minor
ZZ	System default

 

 

 

 

top of page

SUF - Search Results: Select Screen - Spend Down Search Screen Suffix - Assessment Maintenance Menu - Enrollment Menu - Level of Care Screen SUFX - Case Data Screen - Enrollee Demographics Screen - Spend Down Maintenance Screen
I
II
III
IV
V
VI
1st
2nd
3rd
4th
5th
6th
Jr
Sr

 

 

 

 

 

 

 

 

 

 

 

 

 

 

top of page

Type - Managed Care Assignment Screen
C18	Continue 18 months
C36	Continue 36 months
I18	Initial 18 months
I36	Initial 36 months
R24	Reenroll 24 months
R36	Reenroll 36 months

 

 

 

 

 

top of page

Type - TPL Absent Parent Screen
A	Administrative
C	Court Ordered
blank	Not required

 

 

 

 

top of page

Type Coverage - TPL Resource Screen
F	Family
I	Individual
M	Mixed
U	Unknown

 

 

 

 

top of page

 

.................................................................................................................................................
© 2003 VCU-VISSTA. All rights reserved. Last Modified: June 3, 2003 Send comments to VISSTA Media Lab	Virginia Institute for Social Services Training Activities 104 North Linden Street, P.O. Box 842027 Richmond, VA 23284-2027 804.828.0178 FAX: 804.828.1207