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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-1139

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type One Record Type (Single Record)
File Segment Number CLT00002
Data Element Name CLAIM-HEADER-RECORD-LT.MEDICARE-HIC-NUM
Validation Logic 'if CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-LT has a valid, non-null value for MEDICARE-HIC-NUM, then CLAIM-HEADER-RECORD-LT.MEDICARE-HIC-NUM does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the medicare hic number is populated on a non-denied claim from an LT file, then the medicare hic number reported must not contain any pipe or asterisk characters.
Denominator Logic # of LT claim headers with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-LT.MEDICARE-HIC-NUM equal to a valid, non-null value