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TMSIS Dataguide Medicaid.gov
Version 3.38.0

RULE-1262

Validation Rule
Last updated

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type Two Record Type (1 to 1)
File Segment Number CLT00002
Data Element Name CLAIM-LINE-RECORD-LT.STATE-NOTATION
Validation Logic 'if CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-LT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-LT has a valid, non-null value for STATE-NOTATION, then CLAIM-LINE-RECORD-LT.STATE-NOTATION does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the state notation is populated on a non-denied LT claim, then the state notation reported must not contain any pipe or asterisk characters.
Denominator Logic # of LT claim headers with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-LINE-RECORD-LT.CLAIM-LINE-STATUS not in: '26', '87', '542', '585', '654' and with CLAIM-LINE-RECORD-LT.STATE-NOTATION equal to a valid, non-null value