Crosswalk Management System · 2017-11-22 · 16 17 18 DMH Psychiatric Hospital Other MS CMHC DMH MR Facility Private Psychiatric Hospital Other MH Care Provider Other MR Care Provider

REPORT CROSSWALK TO STATE

27-DEC-16 09:05Report Date :

Run by :

Report :

CWMS_PROXY

Filename :

Crosswalk Management System

CWMS_PROXY

Crosswalk Report

Page 2 of 62

Status : FN

Start Date : 01-JUL-10End Date :

Follow-up :

Media ID : Central Data Repository - CDR-MS

MississippiSystem

K

1

2

3

System Transaction Type

State Code

Reporting Date

1

2

3

4

9

-

Add Admissions Records

Add Transfer Records

Change Record (correction)

Change Record (update)

Delete

MS

Add

Add

Change

Change

Delete

State Postal Abbreviation

RCD_TRANS

FIPS State Code

RCD_TRANS

-

-

-

K = Key Field

Treatment Episode Data SetItem No Item Value State System Data

Substance Abuse and Mental Health Services AdministrationCenter for Behavioral Health Statistics and Quality

Central Data Repository/CDRVersion : 1

A

A

C

C

D

-

YYYYMMDD

CWMS_PROXY

Crosswalk Report

Page 3 of 62

MississippiMinimum

K

K

K

K

K

K

1

2

3

4

5

5

State Provider Identifer

Client Identifer (Admission)

Co-Dependent/Collateral

Client Transaction Type

Date of Admission

Date of Admission

1

2

3

1

2

-

Primary

Collateral

Unregistered



YYYYMMDD

No

Yes

No

Admission (SA)

Transfer/Change in Service (SA)

mmddyyyy

ORG_CODE

STATE_ID

ADM_TYPE

RCD_TRANS

ENTSA_DATE

ADM_TYPE

-

-

-

-

-

-

K = Key Field



2

1

2

A

T

m/d/y

No longer effective as of: 06-21-2016

1-15 Characters

Client Id is assigned by each provider, once the client is submitted to the CDR we perform an algorithm to determine if the client has been submitted to the CDR before. If they have we apply the existing state id, if not we assign a new state id. Both IDs can be to 9 numbers. Thestate id number are generated by the CDR sequentially.

YYYYMMDD

YYYYMMDD

CWMS_PROXY

Crosswalk Report

Page 4 of 62

MississippiMinimum

6 Prior Treatment Episodes

0

1

2

3

4

5

8

None

1 previous episode

2 previous episodes

3 previous episodes

4 previous episodes

5 or more previous episodes

Unknown

0 Previous Episodes

1 Previous Episodes

2 Previous Episodes

3 Previous Episodes

4 Previous Episodes

5 Or More Previous Episodes

Unknown

NUM_PRIOR - SA History-

K = Key Field



0

1

2

3

4

5

7

CWMS_PROXY

Crosswalk Report

Page 5 of 62

MississippiMinimum

7 Principal Source of Referral

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

18

DMH Psychiatric Hospital

Other MS CMHC

DMH MR Facility

Private Psychiatric Hospital

Other MH Care Provider

Other MR Care Provider

Other A&D Care Provider

General Hospital/Other Healthcare Provider

Self

Family Friend

School/Educational Agency

Employer/EAP

Police/Sheriff

Court/Correctional Facility

Probation/Parole

Self Help Program

Vocational Rehabilitation/Job Placement

Nursing Home (non-DMH)

Other Health Care Provider






Alcohol/Drug Abuse Provider


Individual (includes self-referral))


School (Educational)

Employer/Employer Assistance ProgramEAP

Court/Criminal Justice/DUI/DWI



Other Community Referral



ADM_REFER-

K = Key Field



03

03

03

03

03

03

02

03

01

01

04

05

07

07

07

06

06

06

CWMS_PROXY

Crosswalk Report

Page 6 of 62

MississippiMinimum


19

20

21

97

98

99

Boarding Home

Group Home (non-DMH)

Other Social Services Agency

Other

Unknown

None




Unknown

Unknown

Unknown

ADM_REFER-

K = Key Field



06

06

03

97

97

97

CWMS_PROXY

Crosswalk Report

Page 7 of 62

MississippiMinimum


01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

18

DMH Psychiatric Hospital

Other MS CMHC

DMH MR Facility

Private Psychiatric Hospital

Other MH Care Provider

Other MR Care Provider

Other A&D Care Provider

General Hospital/Other Healthcare Provider

Self

Family Friend

School/Educational Agency

Employer/EAP

Police/Sheriff

Court/Correctional Facility

Probation/Parole

Self Help Program

Vocational Rehabilitation/Job Placement

Nursing Home (non-DMH)







Alcohol/Drug Abuse Provider




School (Educational)

Employer/Employer Assistance ProgramEAP







ADM_REFER-

K = Key Field



03

03

03

03

03

03

02

03

01

01

04

05

07

07

07

06

06

06

CWMS_PROXY

Crosswalk Report

Page 8 of 62

MississippiMinimum

7

8

9

Principal Source of Referral

Date of Birth

Gender

19

20

21

97

98

99

F

M

U

Boarding Home

Group Home (non-DMH)

Other Social Services Agency

Other

Unknown

None

Female

Male

Unknown




Unknown

Unknown

Unknown

Female

Male

Unknown

ADM_REFER

BIRTH_DATE

SEX

-

-

-

K = Key Field



06

06

06

97

97

97

2

1

7


YYYYMMDD

CWMS_PROXY

Crosswalk Report

Page 9 of 62

MississippiMinimum

10 Race (Hispanic collected as race to be reported as 97 in Race and 06 in Ethnicit

A

B

I

K

M

O

P

U

W

Asian

Black/African American

American Indian

Alaskan Native (Aleut, Eskimo, Indian)

Multiple Races

Other

Native Hawaiian or other Pacific Islander

Unknown

White/Caucasian

Asian

Black or African American

American Indian/Alaskan Native ( States using Alaskan Native in 01 use for other

Alaska Native (Aleut, Eskimo, Indian)

Two or More Races

Other Single Race

Native Hawaiians or Other Pacific Islanders

Unknown

White

RACE-

K = Key Field



13

04

02

01

21

20

23

97

05

CWMS_PROXY

Crosswalk Report

Page 10 of 62

MississippiMinimum

10 Race (Hispanic collected as race to be reported as 97 in Race and 06 in Ethnicit

A

B

I

K

M

N/A

P

U

W

Asian


American Indian


Multiple Races

Not an option in our system


Unknown

White/Caucasian

Asian


American Indian/Alaskan Native ( States using Alaskan Native in 01 use for other

Alaska Native (Aleut, Eskimo, Indian)

Two or More Races

Other Single Race

Native Hawaiians or Other Pacific Islanders

Unknown

White

RACE-

K = Key Field



13

04

02

01

21

20

23

97

05


CWMS_PROXY

Crosswalk Report

Page 11 of 62

MississippiMinimum

11

11

Hispanic or Latino Origin ( Ethnicity)

Hispanic or Latino Origin ( Ethnicity)

C

M

N

O

P

U

U

C

M

N

N/A

O

P

U

Cuban

Mexican

Not of Hispanic origin

Other Hispanic

Puerto Rican

Unknown

Unknown

Cuban

Mexican



Other Hispanic

Puerto Rican

Unknown

Cuban

Mexican

Not of Hispanic or Latino Origin

Other Specific Hispanic

Puerto Rican

Unknown

Hispanic or Latino - Specific Origin not Specified

Cuban

Mexican

Not of Hispanic or Latino Origin

Other Specific Hispanic

Hispanic or Latino - Specific Origin not Specified

Puerto Rican

Unknown

HISPANIC

HISPANIC

-

-

K = Key Field



03

02

05

04

01

97

06

03

02

05

04

06

01

97


CWMS_PROXY

Crosswalk Report

Page 12 of 62

MississippiMinimum

12 Education

01-12

13

14

15

16

17

18

19

51

52

98

99

First Grade - Twelfth Grade

GED

Technical/Trade School

Some College

Associates

Bachelors Degree

Masters Degree

PHD

Preschool/Kindergarten

Special Education

Unknown

Never attended school

Years of School(Highest Grade) ( General Equivalency Degree, use 12)








Less Than One Grade Completed


Unknown


Education-

K = Key Field



01-25

01-25

01-25

01-25

01-25

01-25

01-25

01-25

00

01-25

97

00


CWMS_PROXY

Crosswalk Report

Page 13 of 62

MississippiMinimum

12 Education

01-12

01-12

01-12

01-12

01-12

01-12

01-12

01-12

01-12

01-12

01-12

01-12

13

14

15

16

17

18













GED

Technical/Trade School

Some College

Associates

Bachelors Degree

Masters Degree

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

12th Grade or GED

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 6

12th Grade or GED

Vocational school - business, technical,secretarial, trade or correspondence

1st year of College/Iniversity (Freshman)

2nd year of College/Iniversity (Sophomore)

4th year of College/Iniversity (Senior) or Bachelor's Degree)

Master's Degree Completed

Education-

K = Key Field



01

02

03

04

05

12

07

08

09

10

11

06

12

71

13

14

16

18

CWMS_PROXY

Crosswalk Report

Page 14 of 62

MississippiMinimum

12 Education

19

51

52

98

99

PHD

Preschool/Kindergarten

Special Education

Unknown

Never attended school

Graduate or Professional school - medical, law - includes Master's and Doctorate

Kindergarten

Self-contained special education class

Unknown


Education-

K = Key Field



70

73

74

97

00

CWMS_PROXY

Crosswalk Report

Page 15 of 62

MississippiMinimum

13 Employment Status

01

02

03

04

05

06

07

08

09

10

11

97

98

Employed full time - (35+ hrs week)

Employed - part time

Employed - active military duty

Seasonal/migrant worker

Unemployed - seeking work

Unemployed - not seeking work

Homemaker

Student under 17

Retired

DIsabled

Correctional inmate

Other

Unknown

Full Time - works 35 or more hours a week- includes military

Part Time - works less tahn 35 hours per week



Unemployed - looking for work in past 30 days or on layoff from job

Not in Labor Force - not looking for work in past 30 days - stdent, retired etc.






Unknown

Not Collected

EMPLOYMENT/DIS_EMP-

K = Key Field



01

02

01

02

03

04

04

04

04

04

04

97

98

CWMS_PROXY

Crosswalk Report

Page 16 of 62

MississippiMinimum

14 Substance Problem Codes ( Primary-14A,Secondary-14B, Tertiart-14C)

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

None

Alcohol

Cocaine/Crack

Marijuana/Hashish

Heroin

Non-perscriprtion Methadone

Other Opiates and Synthetics

PCP-phencyclidine

Other Hallucinogens

Methamphetamine

Other Amphetamines

Other Stimulants

Benzodiazepine

Other non Benzodiazepine Tranquilizers

Barbiturates

Other Sedatives or hyponotics

Inhalants

None

Alcohol

Cocaine, Crack

Marijuana, Hashish ( includesTHC and other Cannabis Sativa preperations)

Heroin

Non-Prescription Methadone


PCP

Hallucinogens

Methamphetamine

Other Amphetamines

Other Stimulants

Benzodiazepines

Other Non-Benzodiazapine Tranquilizers

Barbiturates

Other Non-Barbituate Sedatives or Hypnotics

Inhalants

SUB_CODE_1, SUB_CODE_2,SUB_CODE_3/EXT_SUB_1,EXT_SUB_21,EXT_SUB_3

-

K = Key Field



01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

CWMS_PROXY

Crosswalk Report

Page 17 of 62

MississippiMinimum


18

20

98

99

Over the counter

Other Drugs

Unknown

Not Available

Over-the-Counter

Other

Unknown

Unknown


-

K = Key Field



18

20

97

97

CWMS_PROXY

Crosswalk Report

Page 18 of 62

MississippiMinimum


01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

None

Alcohol

Cocaine/Crack

Marijuana/Hashish

Heroin



PCP-phencyclidine

Other Hallucinogens

Methamphetamine

Other Amphetamines

Other Stimulants

Benzodiazepine


Barbiturates


Inhalants

None

Alcohol

Cocaine, Crack

Marijuana, Hashish ( includesTHC and other Cannabis Sativa preperations)

Heroin



PCP

Hallucinogens

Methamphetamine

Other Amphetamines

Other Stimulants

Benzodiazepines

Other Non-Benzodiazapine Tranquilizers

Barbiturates

Other Non-Barbituate Sedatives or Hypnotics

Inhalants


-

K = Key Field



01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

CWMS_PROXY

Crosswalk Report

Page 19 of 62

MississippiMinimum

14

15

Substance Problem Codes ( Primary-14A,Secondary-14B, Tertiart-14C)

Usual Route of Administration ( Primary-15A, Secondary-15B, Tertiar-15C)

18

97

98

99

1

2

3

4

5

7

8

9

Over the counter

Other

Unknown

Not Available

Oral

Smoking

Inhalation

Injection

Suppositories

Other

UNknown

Not Available

Over-the-Counter

Other

Unknown

Unknown

Oral

Smoking

Inhalation

Injection (IV or intramuscular, intradermal or subcutaneous)

Other

Other

Unknown

Not Applicable


RT_ADMIN_1,RT_ADMIN_2,RT_ADMIN_3

-

-

K = Key Field



18

20

97

97

01

02

03

04

20

20

97

96


CWMS_PROXY

Crosswalk Report

Page 20 of 62

MississippiMinimum

16

17

Frequency of Use ( Primary-16A, Secondary-16B, Tertiary-16C)

Age of First Use (Primary-17A, Secondary-17B, Tertiary-17C)

1

2

3

4

5

6

7

8

9

00

01-95

96

98

No use in past month

1-3 times in past month

1-2 times/wk past month


Daily past month

2-3 times daily past month

3+ times daily past month

Unknown

Not applicable

Newborn with substance dependency problem

Age of first use

Not Applicable

Unknown

No use in the past month


1-2 times per week

3-6 times per week

Daily

Daily

Daily

Unknown

Not Applicable

Newborn with a substance dependecy problem

Age at First Use, in years

Not Applicable

Unknown

FREQ_USE_1,FREQ_USE_2,FREQ_USE_3/EXIT_FREQ_1,EXIT_FREQ_2,EXIT_FREQ_3

FIRST_USE_1,FIRST_USE_2,FIRST_USE_3,

-

-

K = Key Field



01

02

03

04

05

05

05

97

96

00

01-95

96

97

CWMS_PROXY

Crosswalk Report

Page 21 of 62

MississippiMinimum

K 18 Type of Services

-

-

110

111

112

161

206

207

309

313

402

404

406

416

417

418

419

420



Crisis Stablization Services

Chemical dependency unit

(MICA)

Community Hospital

Primary Residential Treatment

Teansitional REsidential treatment

Theraputic Day Treatment

Acute Parial Hospitalization

Family Therapy

Evaluation Only

Medication Evaluation & Monitoring

Intake/Biopsycho-social Assesment

Treatment Plan Review

Multi-family Group Therapy

Peer Support

Intensive Outpatient (supercedes 405)

Detoxification Free-standing Residential ( Detox, 24 hour Service)

Rehabilitation/Residential - Hospital (other thandetox)

Detoxification - Hospital Inpatient ( Detox, 24 hour Service)




Rehabilitation/Residential - Short-term, ( 30 days or fewer)

Rehabiliation/Residential - Long-term, ( more than 30 days)

Ambulatory - Non-Intensive Outpatient









Ambulatory - Intensive Outpatient

Services File-

K = Key Field



02

03

01

01

01

01

04

05

07

07

07

07

07

07

07

07

07

06

CWMS_PROXY

Crosswalk Report

Page 22 of 62

MississippiMinimum


424

426

427

428

501

503

509

510

602

603

604

704

706

801

802

809

Integrated Treatment for Co-Occuring Disorder

Individual Therapy ( supercedes 401)

Group Therapy ( supercedes 403)

Nursing Assessment ( supercedes 407)

Case Management

Aftercare- substance abuse

Community Support Services

Targeted Case Management

Mobile Crisis Services

Telephone Emergency/Crisis Response Service

Walk-In Emergency/Crisis Response Service

Alcohol & Drug Prevention

DUI

Staffing - No Treatment Plan Review

No Shows/Cancellations

Urine Drug Screens

















Services File-

K = Key Field



07

07

07

07

07

07

07

07

07

07

07

07

07

07

07

07

CWMS_PROXY

Crosswalk Report

Page 23 of 62

MississippiMinimum


-

-

110

111

112

206

207

309

402

404

406

415

416

417

418

420

424

426





(MICA)




Family Therapy

Evaluation Only


Crisis Intervention







Detoxification Free-standing Residential ( Detox, 24 hour Service)

Rehabilitation/Residential - Hospital (other thandetox)




Rehabilitation/Residential - Short-term, ( 30 days or fewer)

Rehabiliation/Residential - Long-term, ( more than 30 days)












Services File-

K = Key Field



02

03

01

01

01

04

05

07

07

07

07

07

07

07

07

06

07

07

CWMS_PROXY

Crosswalk Report

Page 24 of 62

MississippiMinimum

K 18

19

Type of Services

Medication-Assisted Opioid Therapy

427

428

501

502

503

504

505

506

507

601

602

704

804

N

U

Y



Case Management

Intensive Case Management


MIMS

School Based Services

Individual Therapy Support

Case Management

Emergency Services



Making a plan (MAP) Team Review meeting

No

Unknown

Yes














No

Unknown

Yes

Services File

METHADONE

-

-

K = Key Field



07

07

07

07

07

07

07

07

07

07

07

07

07

2

7

1


CWMS_PROXY

Crosswalk Report

Page 25 of 62

MississippiSupplementalK = Key Field



CWMS_PROXY

Crosswalk Report

Page 26 of 62

MississippiSupplemental

1 Detail Drug Code, Primary

0201

0301

0302

0401

0501

0601

0701

0702

0703

0704

0705

0706

0707

0708

0709

0801

0901

0902

Alcohol

Crack

Other Cocaine

Marijuana/Hashish

Heroin

Non-prescription Methadone

Codeine

Propoxyphene (Darvon)

Oxycodone (Oxycontin)

Meperidine (Demerol)

Hydromorphone (Dilaudid)

Other Opiates or Synthetics

Pentazocine (Talwin)

Hydrocodone (Vicodin)

Tramadol (Ultram)

PCP or PCP Combination

LSD

Other Hallucinogens

Alcohol

Crack

Other Cocaine

Marijuana/Hashish,THC and any other cannabis sativa preparation

Heroine

Non - Prescription Methadone

Codeine


Oxycodone (Oxycotin)






Tramadol (Ultram)

PCP or PCP Combinations

LSD

DMT, mescaline, peyote,STD and Other Hallucinogens

DETAIL_1,DETAIL_2,DETAIL_3,~

K = Key Field



0201

0301

0302

0401

0501

0601

0701

0702

0703

0704

0705

0706

0707

0708

0709

0801

0901

0902

CWMS_PROXY

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Page 27 of 62



1001

1101

1102

1103

1109

1201

1202

1301

1302

1303

1304

1305

1306

1307

1308

1309

1310

1401

1403

Methamphetamine/Speed

Amphetamine

Methylphenidate

MDMA, Ecstasy

Other Amphetamines

Other Stimulants

Methylphenidate (Ritalin)

Alprazolam (Xanax)

Chlordiazepoxide (Librium)

Clorazepate (Tranzene)

Diazepam (Valium)

Flurazepam (Dalmane)

Lorazepam (Ativan)

Triazolam (Halcion)

Other Benzodiazepine

Flunitrazepam (Rohypnol)

Clonazepam (Klonopin, Rivotril)

Meprobamate (Miltown)

Other Tranquilizer


Amphetamine


Methyleneioxymethampetamine (MDMA, Ecstacy

Other Amphetamines

Other Stimulants

Methylphenidate - (Ritalin)

Alprazolam (Xanax)



Diazepam (Valium)


Lorazepam (Ativan)

Triazolam (Halcion)

Halazepam,oxazepam(Serax),Prazepam,Temazepam(Restoril) and other

Flutirazepram (Rohypnol)

Clonazepam - (Klonopin, Rivotril)


Other non-benzodiazepineTranquilizer


K = Key Field



1001

1101

1102

1103

1109

1201

1202

1301

1302

1303

1304

1305

1306

1307

1308

1309

1310

1401

1403

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Page 28 of 62



1501

1502

1503

1509

1601

1602

1603

1604

1605

1701

1702

1703

1704

1705

1801

1809

2001

2002

2003

Phenobarbital

Secobarbital/Amobarbital (Tuinal)

Secobarbital (Seconal)

Other Barbiturate Sedatives

Ethchlorvynol (Placidyl)

Glutethimide (Doriden)

Methaqualone

Other Non-Barbiturate Sedatives

Other Sedatives

Aerosols

Nitrites

Other Inhalants

Solvents

Anesthetics

Diphenhydramine

Other Over-the-counter

Diphenylhydantoin/Phenytoin (Dilantin)

Other Drugs

GHB/GBL

Phenobarbital




Ethclorvynol (Placidyl)


Methaqualone


Other Sedatives

Aerosols

Nitrites

Gasoline,glue, and other inapproriately inhaled products

Solvents (paint thinners and other solvents)

Anesthetics (Choloform,ether, nitrous oxzide and other anesthetics)

Diphenhydramine

Other Over-The-Counter

Dephenylhydantoin/Phenytoin (Dilantin)

Synthetic Cannabinoid (Spice), Carisoprodol (Soma) and other drugs

GHB/GBL - ( gamma-hyroxybutyrate, gamma-butyrolactone)


K = Key Field



1501

1502

1503

1509

1601

1602

1603

1604

1605

1701

1702

1703

1704

1705

1801

1809

2001

2002

2003

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Page 29 of 62



2004

9998

9999

Ketamine (Special K)

Unknown

Not available

Ketamine - ( Special K)

Unknown

Not Applicable


K = Key Field



2004

9997

9996


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Page 30 of 62



0201

0301

0302

0401

0501

0601

0701

0702

0703

0704

0705

0706

0707

0708

0709

0710

0801

0901

Alcohol

Crack

Other Cocaine

Marijuana/Hashish

Heroin

Non-prescription Methadone

Codeine


Oxycodone (Oxycontin)






Tramadol (Ultram)

Buprenorphine (Subutex, Suboxone)

PCP or PCP Combination

LSD

Alcohol

Crack

Other Cocaine

Marijuana/Hashish,THC and any other cannabis sativa preparation

Heroine

Non - Prescription Methadone

Codeine


Oxycodone (Oxycotin)






Tramadol (Ultram)

Buprenorphine (Subutex,Suboxone)

PCP or PCP Combinations

LSD


K = Key Field



0201

0301

0302

0401

0501

0601

0701

0702

0703

0704

0705

0706

0707

0708

0709

0710

0801

0901

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0902

1001

1101

1102

1103

1109

1201

1202

1301

1302

1303

1304

1305

1306

1307

1308

1309

1310

1401

Other Hallucinogens


Amphetamine

Methylphenidate

MDMA, Ecstasy

Other Amphetamines

Other Stimulants


Alprazolam (Xanax)



Diazepam (Valium)


Lorazepam (Ativan)

Triazolam (Halcion)

Other Benzodiazepine

Flunitrazepam (Rohypnol)

Clonazepam (Klonopin, Rivotril)


DMT, mescaline, peyote,STD and Other Hallucinogens


Amphetamine


Methyleneioxymethampetamine (MDMA, Ecstacy

Other Amphetamines

Other Stimulants

Methylphenidate - (Ritalin)

Alprazolam (Xanax)



Diazepam (Valium)


Lorazepam (Ativan)

Triazolam (Halcion)

Halazepam,oxazepam(Serax),Prazepam,Temazepam(Restoril) and other

Flutirazepram (Rohypnol)

Clonazepam - (Klonopin, Rivotril)



K = Key Field



0902

1001

1101

1102

1103

1109

1201

1202

1301

1302

1303

1304

1305

1306

1307

1308

1309

1310

1401

CWMS_PROXY

Crosswalk Report

Page 32 of 62



1403

1501

1502

1503

1509

1601

1602

1603

1604

1701

1702

1703

1704

1705

1801

1809

2001

2002

2003

Other Tranquilizer

Phenobarbital




Ethchlorvynol (Placidyl)


Methaqualone


Aerosols

Nitrites

Other Inhalants

Solvents

Anesthetics

Diphenhydramine

Other Over-the-counter

Diphenylhydantoin/Phenytoin (Dilantin)

Other Drugs

GHB/GBL

Other non-benzodiazepineTranquilizer

Phenobarbital




Ethclorvynol (Placidyl)


Methaqualone


Aerosols

Nitrites

Gasoline,glue, and other inapproriately inhaled products

Solvents (paint thinners and other solvents)

Anesthetics (Choloform,ether, nitrous oxzide and other anesthetics)

Diphenhydramine

Other Over-The-Counter

Dephenylhydantoin/Phenytoin (Dilantin)

Synthetic Cannabinoid (Spice), Carisoprodol (Soma) and other drugs

GHB/GBL - ( gamma-hyroxybutyrate, gamma-butyrolactone)


K = Key Field



1403

1501

1502

1503

1509

1601

1602

1603

1604

1701

1702

1703

1704

1705

1801

1809

2001

2002

2003

CWMS_PROXY

Crosswalk Report

Page 33 of 62


1

2

3

4

4

Detail Drug Code, Primary

Detail Drug Code, Secondary

Detail Drug Code, Tertiary

Diagnostic Code (DSM or ICD) field should be coded 999.98 - field 19 replaces i

Diagnostic Code (DSM or ICD) field should be coded 999.98 - field 19 replaces i

2004

9998

9999

V7109

xxx.xx

999.98

Ketamine (Special K)

Unknown

Not available

No Diagnosis

DSM Code

Not collected

Ketamine - ( Special K)

Unknown

Not Applicable

Same as Detail Drug Code, Primary

Same as Detail Drug Code, Primary

Unknown

DSM/ICD codes

Not Collected

DETAIL_1,DETAIL_2,DETAIL_3,



DSM_1

Not collected

~

~

~

~

-

K = Key Field



2004

9997

9996

_

_

999.97

XXX.XX

999.98


CWMS_PROXY

Crosswalk Report

Page 34 of 62


5

6

6

Psychiatric Problem in Addition to Alcohol or Drug Problem

Pregnant at Admission

Pregnant at Admission

N

U

Y

N

U

X

Y

N

U

Y

No

Unknown

Yes

No

Unknown

Not Applicable

Yes

No

Unknown

Yes

No

Unknown

Yes

No - female client was not pregnant at admission

Unknown

Not Applicable - use this code for male clients or children in prepuberty age

Yes - female client was pregnant at admission

No - female client was not pregnant at admission

Unknown

Yes - female client was pregnant at admission

PSYCHIAT

PREGNANT

PREGNANT

~

~

~

K = Key Field



2

7

1

2

7

6

1

2

7

1


CWMS_PROXY

Crosswalk Report

Page 35 of 62


7

8

Veteran Status

Living Arrangements

N

U

Y

01

02

03

04

05

06

08

09

10

11

99

No

Unknown

Yes

Private Residence

Other Independent

Homeless Shelter

Institution

Community Program

Correctional Facility

Foster Care

Residential Care

Crisis Residence

Childrens Residential Treatment

Unknown

No

Unknown

Yes

Independent Living - clients living alone or with others but no supervision


Homeless - clients with no fixed address; includes homeless shelter

Dependent Living - clients living in a supervised setting







Unknown

VET_STATUS

RESID_ARR/DIS_RES

~

~

K = Key Field



2

7

1

03

03

01

02

02

02

02

02

02

02

97

CWMS_PROXY

Crosswalk Report

Page 36 of 62


9

10

Source of Income/Support

Health Insurance

1

2

3

4

7

8

9

01

02

03

04

05

97

98

99

Wages/Salary

Public Assisstance

Retirement/Pension

Disability

Other

Unknown

None

Private Insurance

Blue Cross/Blue Shield

Medicare

Medicaid

Health Maintenance Organization (HMO)

Other (E.G. TriCare)

Unknown

None

Wages/Salary

Public Assistance

Retirement/Pension

Disability

Other

Unknown

None

Private Insurance (other than BCBS or HMO)


Medicare

Medicaid

Health Maintenance Organization (HMO)

Other (e.g. TriCare)

Unknown

None

INCOME_SRC

INSURAN_1

~

~

K = Key Field



01

02

03

04

20

97

21

01

02

03

04

06

20

97

21

CWMS_PROXY

Crosswalk Report

Page 37 of 62


11 Expected/Actual Primary Source of Payment

-

-

-

-

-

-

-

-

-

-

-

-

-

Non-Medicaid

Non-Medicaid

Non-Medicaid

Non-Medicaid

Non-Medicaid

Non-Medicaid

Non-Medicaid

Non-Medicaid

None

Both Medicaid & Non-Medicaid

Not Reported/Unknown

Medicaid

Non-Medicaid

Self-Pay


Medicare

Other Government Payments



Other Health Insurance Companies

Worker's Compensation

No Charge ( Free, Charity, Special Research or Teaching)

Other

Unknown

Medicaid


PAYMENT~

K = Key Field



01

02

03

05

05

05

07

06

08

09

97

04

05

CWMS_PROXY

Crosswalk Report

Page 38 of 62


11 Expected/Actual Primary Source of Payment

01

02

03

04

05

06

07

08

09

10

11

12

97

98

None

Personal Resources

Service Contract


TriCare

Other Commercial Insurance

Medicare

Medicaid

VA

Worker's Comp

Other public (government)

CHIP (Children's Health Insurance Program)

Other Source of Payment

Unknown

No Charge ( Free, Charity, Special Research or Teaching)

Self-Pay




Other Health Insurance Companies

Medicare

Medicaid


Worker's Compensation



Other

Unknown

PAYMENT~

K = Key Field



08

01

05

02

05

07

03

04

05

06

05

05

09

97


CWMS_PROXY

Crosswalk Report

Page 39 of 62


12

12

Detailed Not in Labor Force

Detailed Not in Labor Force

06

07

08

09

10

11

97

98

01-05

07

08

09

10

11

97

98


Homemaker

Student under 17

Retired

DIsabled

Correctional inmate

Other

Unknown

Employed statuses will be reported as 96 N/A

Homemaker

Student under 17

Retired

DIsabled

Correctional inmate

Other

Unknown

Other

Homemaker

Student

Retired

Disabled

Inmate of Institution ( Prison or Institution - keeps people out of work force)

Other

Unknown

Not Applicable

Homemaker

Student

Retired

Disabled


Other

Unknown

EMPLOYMENT/DIS_EMP

EMPLOYMENT/DIS_EMP

-

-

K = Key Field



06

01

02

03

04

05

06

97

96

01

02

03

04

05

06

97


CWMS_PROXY

Crosswalk Report

Page 40 of 62


13

14

Detailed Criminal Justice Referral Categories

Marital Status

01

02

03

04

05

06

07

97

98

D

M

P

S

U

W

State/Federal Court

Formal Adjudication Process

Probation/Parole

Other Recognized Legal Entity

Diversionary Program

Prison

DUI/DWI

Other

Unknown

Divorced

Married

Separated

Single

Unknown

Widowed

State/Federal Court

Other Court ( Not State or Federal)

Probation/Parole

Other Recognized Legal Entity ( Local Law, Corr. Agncy, Youth Ser., Review Board

Diversionary Program (E.G. TASC)

Prison

DUI/DWI

Other

Unknown

Divorced

Now Married ( includes those living together as married)

Separated (legally seperated or otherwise absentbecasue of marital discord))

Never Married - includes clients who are single or whose

Unknown

Widowed

JUS_REFER

MARITAL

~

~

K = Key Field



01

02

03

04

05

06

07

08

97

04

02

03

01

97

05

CWMS_PROXY

Crosswalk Report

Page 41 of 62


15

16

17

18

19

Days Waiting to Enter Treatment

Number of Arrests in the 30 Days Prior to Admission

Frequency of Attendance at Self-Help Programs in 30 days prior to Admission

Diagnostic Code Set

Diagnostic Code (ICD-10 Form)

000-996

998

00

01-96

98

4

5

6

xxx.xxxx

Days Waiting

Unknown

None

Number of Arrests

Unknown

DSM-IV

DS-5 (ICD-9 code)

DSM-5 (ICD-10 code)

xxx.xxxx

Number of Days waiting

Unknown

Number of Arrests

Number of Arrests

Unknown

DSM-IV

DSM-V

ICD-10

7 digit code

DAYS_WAIT

ARRESTS/DIS_ARREST

Not Currently in Our System

DCS_ID

DIAGNOSIS_1

~

~

-

~

~

K = Key Field



000-996

997

00-96

00-96

97

1

4

3

xxx.xxxx

CWMS_PROXY

Crosswalk Report

Page 42 of 62

MississippiDischarge/NOMS

1

2

3

4

5

6

System Transaction at Discharge

State Code at Discharge

Reporting Date at Discharge

State Provider Identifer at Discharge

Client Identifier at Discharge

Co-Dependent/Collateral at Discharge

1

2

3

4

9

-



Change Record (correction)

Change Record (update)

Delete

MS

Add

Add

Change

Change

Delete

State abreviation according postal codes

Same as admission file

RCD_TRANS

FIPS State Code

Date Reported Submitted

ORG_CODE

STATE_ID

ADM_TYPE

-

-

-

-

-

-

K = Key Field



A

A

C

C

D

-

-

YYYYMMDD

1-15 Characters

Client Id is assigned by each provider, once the client is submitted to the CDR we perform an algorithm to determine if the client has been submitted to the CDR before. If they have we apply the existing state id, if not we assign a new state id. Both IDs can be to 9 numbers. Thestate id number are generated by the CDR sequentially.

CWMS_PROXY

Crosswalk Report

Page 43 of 62


7

8

9

10

Type of Treatment Service/Treatment Setting at Discharge

Date of Last Contact or Data Update

Date of Discharge

Reason for Discharge, Transfer, or Discontinuance of Treatment

-

-

1

2

3

4

5

6

7

8

Not Collected in our System


Evaluation Only

Treatment Completed

Therapist Terminated Treatment

CLient Referred Elsewhere

Client Terminated Treatment

Client Moved from Region

Client deceased

No Contact with Consumer within Specified Time Range

Same as admission file

Incarerated or released by or to courts

Transferred to Trtment Prog or Facil, but did notreport

Other - includes aging out of MH childrens system, extended placement (condition

Treatment Completed

Ternimated by Facility

Transferred to Another Treatment Program or Facility

Dropped out of treatment (lost contact, Left Against Professional Advice


Death


Services File

SA_EXT_DATE

SA_DIS_DATE

SA_DIS_STAT

-

*

*

*

K = Key Field



-

05

14

07

01

03

04

02

07

06

02

YYYYMMDD

YYYYMMDD

CWMS_PROXY

Crosswalk Report

Page 44 of 62


10

11

12

Reason for Discharge, Transfer, or Discontinuance of Treatment

Provider Identifier at Admission

Client Identifier at Admission

-

-

1

2

3

4

5

6

7

8



Evaluation Only

Treatment Completed

Therapist Terminated Treatment

CLient Referred Elsewhere

Client Terminated Treatment

Client Moved from Region

Client deceased

No Contact with Consumer within Specified Time Range

Transferred to Trtment Prog or Facil, but did notreport

Incarerated or released by or to courts


Treatment Completed

Ternimated by Facility

Transferred to Another Treatment Program or Facility



Death


SA_DIS_STAT

ORG_CODE

STATE_ID

*

-

-

K = Key Field



14

05

07

01

03

04

02

07

06

07


1-15 Characters

Client ID is assigned by each provider, once the client is submitted to the CDR we perform an algorithm to determine if the client has beensubmitted to the CDR before. If they have, we apply the existing state id, if not we assign a new state id. Both IDs can be to 9 numbers. The state id number are generated by tthe CDR sequentially.

CWMS_PROXY

Crosswalk Report

Page 45 of 62


13

14

15

Co-Depentent/Collateral at Admission

Client Transaction Type (pulled from admission dataset)

Date of Admission (pulled from admission dataset)

1

2

3

1

2

Primary

Collateral

Unregistered



Client

Codependent/collateral

Client

Initial Admission (SA)

Transfer or change in service (SA)

ADM_TYPE

RCD_TRANS

ADM_TYPE

-

-

-

K = Key Field



2

1

2

A

T

YYYYMMDD

CWMS_PROXY

Crosswalk Report

Page 46 of 62


16 Type of Service at Admission (pulled from admission dataset)

-

-

110

111

112

206

207

309

402

404

406

415

416

417

418

420

424

426





(MICA)




Family Therapy

Evaluation Only


Crisis Intervention







Detoxification , 24 hour service , Free-StandingResidential

Rehabilitation/Residential - Hospital (other thanDetoxification)

Detoxification, 24-hour service - Hospital Inpatient



Rehabilitation/Residential - Short Term (30 days or fewer)

Rehabilitation/Residential - Long Term (more than 30 days)












Services File-

K = Key Field



02

03

01

01

01

04

05

07

07

07

07

07

07

07

07

06

07

07

CWMS_PROXY

Crosswalk Report

Page 47 of 62



427

428

501

502

503

504

505

506

507

601

602

704

804



Case Management

Intensive Case Management


MIMS

School Based Services

Individual Therapy Support

Case Management

Emergency Services



Making a plan (MAP) Team Review meeting














Services File-

K = Key Field



07

07

07

07

07

07

07

07

07

07

07

07

07


CWMS_PROXY

Crosswalk Report

Page 48 of 62



-

-

110

111

112

161

206

207

309

313

402

404

406

416

417

418

419

420





(MICA)

Community Hospital




Acute Parial Hospitalization

Family Therapy

Evaluation Only





Peer Support


Detoxification , 24 hour service , Free-StandingResidential

Rehabilitation/Residential - Hospital (other thanDetoxification)





Rehabilitation/Residential - Short Term (30 days or fewer)

Rehabilitation/Residential - Long Term (more than 30 days)











Services File-

K = Key Field



02

03

01

01

01

01

04

05

07

07

07

07

07

07

07

07

07

06

CWMS_PROXY

Crosswalk Report

Page 49 of 62


16

17

Type of Service at Admission (pulled from admission dataset)

Date of Birth (pulled from admission dataset)

424

426

427

428

503

509

510

602

603

604

704

706

801

802

809






Community Support Services

Targeted Case Management


Telephone Emergency/Crisis Response Service

Walk-In Emergency/Crisis Response Service


DUI

Staffing - No Treatment Plan Review

No Shows/Cancellations

Urine Drug Screens
















Services File

BIRTH_DATE

-

-

K = Key Field



07

07

07

07

07

07

07

07

07

07

07

07

07

07

07

YYYYMMDD

CWMS_PROXY

Crosswalk Report

Page 50 of 62


18

19

Gender (pulled from admission dataset)

Race (pulled from admission dataset)

F

M

U

A

B

I

K

M

N/A

P

U

W

Female

Male

Unknown

Asian


American Indian


Multiple Races



Unknown

White/Caucasian

Female

Male

Unknown

Asian


American Indian

Alaskan Native (Aleut, Eskimo)

Two or more races

Other single race


Unknown

White

SEX

RACE

-

-

K = Key Field



2

1

7

13

04

02

01

21

20

23

97

05


CWMS_PROXY

Crosswalk Report

Page 51 of 62


19 Race (pulled from admission dataset)

A

B

I

K

M

O

P

U

W

Asian


American Indian


Multiple Races

Other


Unknown

White/Caucasian

Asian


American Indian

Alaskan Native (Aleut, Eskimo)

Two or more races

Other single race


Unknown

White

RACE-

K = Key Field



13

04

02

01

21

20

23

97

05

CWMS_PROXY

Crosswalk Report

Page 52 of 62


20

20

Ethnicity (pulled from admission dataset)

Ethnicity (pulled from admission dataset)

C

M

N

N/A

O

P

U

C

M

N

O

P

U

U

Cuban

Mexican



Other Hispanic

Puerto Rican

Unknown

Cuban

Mexican


Other Hispanic

Puerto Rican

Unknown

Unknown

Cuban

Mexican

Not of Specific Hispanic or Latino Origin

Other Specific Hispanic or Latino

Hispanic or Latino - specific origin not specified

Puerto Rican

Unknown

Cuban

Mexican

Not of Specific Hispanic or Latino Origin

Other Specific Hispanic or Latino

Puerto Rican

Hispanic or Latino - specific origin not specified

Unknown

HISPANIC

HISPANIC

-

-

K = Key Field



03

02

05

04

06

01

97

03

02

05

04

01

06

97


CWMS_PROXY

Crosswalk Report

Page 53 of 62


21 Substance Problem At Discharge, (Primary, Secondary, Tertiary)

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

18

None

Alcohol

Cocaine/Crack

Marijuana/Hashish

Heroin



PCP-phencyclidine

Other Hallucinogens

Methamphetamine

Other Amphetamines

Other Stimulants

Benzodiazepine


Barbiturates


Inhalants

Over the counter

None

Alcohol

Cocaine/Crack

Marijuana/Hashish

Heroin



PCP- phencyclidine

Hallucinogens

Methampetamine/SPeed

Other Amphetamines

Other Stimulants

Benzodiazepines

Other Tranquilizer

Barbiturates

Other Sedatives or Hypontics

Inhalants

Over-The-Counter medicines


-

K = Key Field



01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

18

CWMS_PROXY

Crosswalk Report

Page 54 of 62



20

98

99

Other Drugs

Unknown

Not Available

Other

Unknown

Unknown


-

K = Key Field



20

97

97

CWMS_PROXY

Crosswalk Report

Page 55 of 62



01

02

03

05

06

07

08

09

10

11

12

13

14

15

16

17

18

97

None

Alcohol

Cocaine/Crack

Heroin



PCP-phencyclidine

Other Hallucinogens

Methamphetamine

Other Amphetamines

Other Stimulants

Benzodiazepine


Barbiturates


Inhalants

Over the counter

Other

None

Alcohol

Cocaine/Crack

Heroin



PCP- phencyclidine

Hallucinogens

Methampetamine/SPeed

Other Amphetamines

Other Stimulants

Benzodiazepines

Other Tranquilizer

Barbiturates

Other Sedatives or Hypontics

Inhalants

Over-The-Counter medicines

Other


-

K = Key Field



01

02

03

05

06

07

08

09

10

11

12

13

14

15

16

17

18

20

CWMS_PROXY

Crosswalk Report

Page 56 of 62


21

22

Substance Problem At Discharge, (Primary, Secondary, Tertiary)

Frequency of Use at Discharge (Primary, Secondary, Tertiary)

98

99

1

2

3

4

5

6

7

8

9

Unknown

Not Available

No use in past month




Daily past month

2-3 times daily past month

3+ times daily past month

Unknown

Not applicable

Unknown

Unknown

No Use in the Past Month

1-3 Times in the Past Month

1-2 Times in the Past Week

3-6 Times in the Past Week

Daily

Daily

Daily

Unknown

Not Applicable


FREQ_USE_1,FREQ_USE_2,FREQ_USE_3/EXIT_FREQ_1,EXIT_FREQ_2,EXIT_FREQ_3

-

-

K = Key Field



97

97

01

02

03

04

05

05

05

97

96


CWMS_PROXY

Crosswalk Report

Page 57 of 62


23 Living Arrangements at Discharge

01

02

03

04

05

06

08

09

10

11

99

Private Residence

Other Independent

Homeless Shelter

Institution

Community Program


Foster Care

Residential Care

Crisis Residence


Unknown











Unknown

RESID_ARR/DIS_RES~

K = Key Field



03

03

01

02

02

02

02

02

02

02

97


CWMS_PROXY

Crosswalk Report

Page 58 of 62


23 Living Arrangements at Discharge

01

02

03

04

05

06

07

08

09

10

11

99

Private Residence

Other Independent

Homeless Shelter

Institution

Community Program


Other

Foster Care

Residential Care

Crisis Residence


Unknown







Unknown





Unknown

RESID_ARR/DIS_RES~

K = Key Field



03

03

01

02

02

02

97

02

02

02

02

97

CWMS_PROXY

Crosswalk Report

Page 59 of 62


24 Employment at Discharge

01

02

03

04

05

06

07

08

09

10

11

97

98

Employed full time - (35+ hrs week)

Employed - part time

Employed - active military duty

Seasonal/migrant worker

Unemployed - seeking work


Homemaker

Student under 17

Retired

DIsabled

Correctional inmate

Other

Unknown





Unemployed - looking for work in past 30 days or on layoff from job







Unknown

Not Collected

EMPLOYMENT/DIS_EMP-

K = Key Field



01

02

01

02

03

04

04

04

04

04

04

97

98

CWMS_PROXY

Crosswalk Report

Page 60 of 62


25

26

27

Detailed Not In Labor Force at Discharge

Number of Arrests in 30 Days Priorto Discharge

Frequency of Attendance at Self-Help program in the 30 Days Prior to Discharge

06

07

08

09

10

11

97

98

00

01-96

98


Homemaker

Student under 17

Retired

DIsabled

Correctional inmate

Other

Unknown

None

Number of Arrests

Unknown

Other

Homemaker

Student

Retired

Disabled


Other

Unknown

Number of Arrests

Number of Arrests

Unknown

EMPLOYMENT/DIS_EMP

ARRESTS/DIS_ARREST

Not Currently in Our System

-

~

-

K = Key Field



06

01

02

03

04

05

06

97

00-96

00-96

97

CWMS_PROXY

Crosswalk Report

Page 61 of 62


28 Client Transaction Type - Discharge

09

10

Discharged

Discharged - outpatient commitment (SPHs)

Discharge (SA)

Discharge (SA)

CLI_STATUS-

K = Key Field



D

D

REPORT CROSSWALK TO STATE

Crosswalk Management System

End of Report

Documents

Crosswalk Management System · 2017-11-22 · 16 17 18 DMH Psychiatric Hospital Other MS CMHC DMH MR Facility Private Psychiatric Hospital Other MH Care Provider Other MR Care Provider