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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-494

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 CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.ADMISSION-DATE • CLAIM-HEADER-RECORD-IP.DISCHARGE-DATE
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 DISCHARGE-DATE and CLAIM-HEADER-RECORD-IP has a valid, non-null value for ADMISSION-DATE, then CLAIM-HEADER-RECORD-IP.ADMISSION-DATE is less than or equal to CLAIM-HEADER-RECORD-IP.DISCHARGE-DATE'
Rule Definition If discharge date and admission date are populated on a non-denied claim from an IP file, then the admission date value reported must be before or equal to the discharge date value reported.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' AND with CLAIM-HEADER-RECORD-IP.DISCHARGE-DATE equal to a valid, non-null value AND with CLAIM-HEADER-RECORD-IP.ADMISSION-DATE equal to a valid, non-null value