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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-7543

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 COT00002
Data Element Name CLAIM-HEADER-RECORD-OT.ADJUSTMENT-IND
Validation Logic 'if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS equals '686', then CLAIM-HEADER-RECORD-OT.ADJUSTMENT-IND equals '1''
Rule Definition If a segment is an OT claim header, and claim status is equal to '686' (void claim), then adjustment indicator must be equal to '1' (void).
Denominator Logic # of OT claim headers with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS is equal to '686'