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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-923

Validation Rule
Last updated

No Updates

Tier 2.0
Tier Description Relational error
Error Category E2001
Error Category Message Values inconsistently specified (single record type, single record)
Rule Type One Record Type (Single Record)
File Segment Number CLT00002
Data Element Name CLAIM-HEADER-RECORD-LT.ADMISSION-DATE • CLAIM-HEADER-RECORD-LT.DISCHARGE-DATE
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 DISCHARGE-DATE and CLAIM-HEADER-RECORD-LT has a valid, non-null value for ADMISSION-DATE, then CLAIM-HEADER-RECORD-LT.ADMISSION-DATE is less than or equal to CLAIM-HEADER-RECORD-LT.DISCHARGE-DATE'
Rule Definition If a claim is a non-denied claim from an LT file and the discharge date is populated and the admission date is populated in the claim header, then admission date is less than or equal to the discharge date.
Denominator Logic # of LT claim headers with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-LT.DISCHARGE-DATE equal to a valid, non-null value and with CLAIM-HEADER-RECORD-LT.ADMISSION-DATE equal to a valid, non-null value