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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

RULE-8619

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1103
Error Category Message Value not in specified valid value set
Rule Type Valid Value
File Segment Number FTX00009
Data Element Name FQHC-WRAP-PAYMENT.MBESCBES-CATEGORY-OF-SERVICE
Validation Logic 'if the MBESCBES-CATEGORY-OF-SERVICE field is populated and FQHC-WRAP-PAYMENT.MBESCBES-FORM-GROUP equals '2' and FQHC-WRAP-PAYMENT has a non-null value for MBESCBES-FORM, then the value must be contained in the set of valid values with id: '64.21COS' and (if FQHC-WRAP-PAYMENT.WRAP-PERIOD-END-DATE is non-null then FQHC-WRAP-PAYMENT.WRAP-PERIOD-END-DATE >= Valid Values Effective-Date and FQHC-WRAP-PAYMENT.WRAP-PERIOD-END-DATE <= Valid Values End-Date)'
Rule Definition If the MBESCBES category of service is populated and MBESCBES form is populated on the FQHC Wrap Payment Transaction from a FTX file, then the MBESCBES category of service reported must be found in the list of valid values for '64.21COS'.
Denominator Logic # of FTX FQHC Wrap Payment Transactions with FQHC-WRAP-PAYMENT.MBESCBES-CATEGORY-OF-SERVICE equal to a valid, non-null value and with FQHC-WRAP-PAYMENT.MBESCBES-FORM-GROUP is equal to '2' and with FQHC-WRAP-PAYMENT.MBESCBES-FORM has non null value'