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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

RULE-8665

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Missing Value Error
Error Category E1105
Error Category Message Data Element Value is Missing
Rule Type One Record Type (Single Record)
File Segment Number FTX00002
Data Element Name INDIVIDUAL-CAPITATION-PMPM.MBESCBES-CATEGORY-OF-SERVICE
Validation Logic 'if INDIVIDUAL-CAPITATION-PMPM.SUBCAPITATION-IND equals '1', then If the INDIVIDUAL-CAPITATION-PMPM segment is populated, then INDIVIDUAL-CAPITATION-PMPM has a non-null value for MBESCBES-CATEGORY-OF-SERVICE'
Rule Definition If the Individual Capitation Payment segment is populated and transaction is not a sub-capitation payment or recoupment from a FTX file, then the MBESCBES-CATEGORY-OF-SERVICE must be populated
Denominator Logic # of FTX Individual Capitation Payment Transactions with SUBCAPITATION-IND is equal to '1'