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TMSIS Dataguide Medicaid.gov
Version 3.38.0

RULE-398

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 CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.DIAGNOSIS-CODE-10
Validation Logic 'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP has a null or invalid value for DIAGNOSIS-CODE-9, then CLAIM-HEADER-RECORD-IP has a null or invalid value for DIAGNOSIS-CODE-10'
Rule Definition If a non-denied IP claim does not have a value populated for diagnosis code 9, then the claim does not have a value populated for diagnosis code 10.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-IP.DIAGNOSIS-CODE-9 equal to a null or invalid value