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TMSIS Dataguide Medicaid.gov
Version 3.38.0

RULE-7929

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Admission Date
File Type CIP
Measure ID RULE-7929
Measure Type Claims Percentage
Content area ALL MULTI PRO

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area N/A
Category Provider enrollment

Claim Information

Claim Type Medicaid,FFS or CHIP,FFS
Adjustment Type Original and Replacement
Crossover Type All Indicators

Thresholds

Minimum 0
Maximum 0.02
TA Minimun 0
TA Maximum 0.02
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element ENDING-DATE-OF-SERVICE • BEGINNING-DATE-OF-SERVICE • PROV-IDENTIFIER • SUBMITTING-STATE-PROV-ID • BILLING-PROV-NUM
DD Data Element Number CLT049 • CLT048 • PRV081 • PRV019 • CLT130

Annotation N/A
Specification RULE-7929