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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-1562

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 COT00002
Data Element Name CLAIM-HEADER-RECORD-OT.REMITTANCE-NUM
Validation Logic 'if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-OT has a valid, non-null value for REMITTANCE-NUM, then CLAIM-HEADER-RECORD-OT.REMITTANCE-NUM does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the remittance number is populated on a non-denied claim header from an OT file, then the remittance number reported must not contain any pipe or asterisk characters.
Denominator Logic # of OT claim headers with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-OT.REMITTANCE-NUM has a valid, non-null value