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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-6245

Validation Rule
Last updated

No Updates

Tier 1.0
Tier Description Formatting Error
Error Category E1001
Error Category Message Value illegal for specified data type
Rule Type Parse Rule
File Segment Number CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.PROCEDURE-CODE-FLAG-3
Validation Logic if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2', then Value must be compatible with specified T-MSIS picture format: X(2)
Rule Definition If a claim is a non-denied claim from an IP file, then the procedure code flag 3 value reported must be compatible with specified T-MSIS picture format: X(2).
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2'