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TMSIS Dataguide Medicaid.gov
Version 3.38.0

RULE-2154

Validation Rule
Last updated

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 ELG00005
Data Element Name ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE
Validation Logic 'If the RESTRICTED-BENEFITS-CODE field is populated, the value must be contained in the set of valid values with id: 'RESTRICTED-BENEFITS-CODE' and (if ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE is non-null then ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE >= Valid Values Effective-Date and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE <= Valid Values End-Date)'
Rule Definition If restricted benefits code is populated on an eligibility determinants segment from an ELG file, then the restricted benefits code value reported must be in the list of valid values for restricted benefits code.
Denominator Logic # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equal to a valid, non-null value