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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-748

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 CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.MEDICARE-BENEFICIARY-IDENTIFIER
Validation Logic 'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP has a valid, non-null value for MEDICARE-BENEFICIARY-IDENTIFIER, then CLAIM-HEADER-RECORD-IP.MEDICARE-BENEFICIARY-IDENTIFIER does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the medicare beneficiary identifer is populated on a non-denied claim from an IP file, then the medicare beneficiary identifer reported must not contain any pipe or asterisk characters.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-IP.MEDICARE-BENEFICIARY-IDENTIFIER equal to a valid, non-null value