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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-960

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 CLT00002
Data Element Name CLAIM-HEADER-RECORD-LT.CLAIM-PYMT-REM-CODE-1 • CLAIM-HEADER-RECORD-LT.CLAIM-PYMT-REM-CODE-2 • CLAIM-HEADER-RECORD-LT.CLAIM-PYMT-REM-CODE-3 • CLAIM-HEADER-RECORD-LT.CLAIM-PYMT-REM-CODE-4
Validation Logic 'if CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY does not equal 'F2', then The values of the following fields should be unique for each CLAIM-HEADER-RECORD-LT record: CLAIM-PYMT-REM-CODE-1, CLAIM-PYMT-REM-CODE-2, CLAIM-PYMT-REM-CODE-3, CLAIM-PYMT-REM-CODE-4'
Rule Definition If more than one CLAIM-PYMT-REM-CODE is populated on a non-denied LT claim, then each of the CLAIM-PYMT-REM-CODE values must be unique.
Denominator Logic # of LT claim headers with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY not equal to 'F2'