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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-1685

Validation Rule
Last updated

No Updates

Tier 2.1
Tier Description Relational error
Error Category E2102
Error Category Message Values inconsistently specified (multi record, single file)
Rule Type Two Record Type (1 to 1)
File Segment Number COT00002
Data Element Name CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN2 • CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN1
Validation Logic 'if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for DESTINATION-ADDR-LN2 and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN2 does not equal CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN1'
Rule Definition If a non-denied OT claim line destination address line 2 is populated, then destination address line 2 is not equal to destination address line 1.
Denominator Logic # of OT claim lines with CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS not in: '26', '87', '542', '585', '654' and with CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN2 equal to a valid, non-null value and with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2'