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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-7186

Validation Rule
Last updated

Tier 0
Tier Description File specification error
Error Category E0003
Error Category Message Duplicate record identifier (RECORD-NUM or primary key values)
Rule Type One Record Type (Multi Record)
File Segment Number CRX00002
Data Element Name CLAIM-HEADER-RECORD-RX.SUBMITTING-STATE • CLAIM-HEADER-RECORD-RX.ICN-ORIG • CLAIM-HEADER-RECORD-RX.ICN-ADJ • CLAIM-HEADER-RECORD-RX.ADJUDICATION-DATE • CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND
Validation Logic Fields SUBMITTING-STATE,ICN-ORIG,ICN-ADJ,ADJUDICATION-DATE,ADJUSTMENT-IND should be unique across all records of type CLAIM-HEADER-RECORD-RX
Rule Definition If a claim header is from an RX file, then submitting state, original ICN, adjustment ICN, adjudication date, and adjustment indicator values reported must be unique across all RX claim headers.
Denominator Logic # of RX claim headers