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TMSIS Dataguide Medicaid.gov
Version 3.38.0

RULE-7334

Validation Rule
Last updated

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.ICN-ADJ
Validation Logic 'if CLAIM-HEADER-RECORD-LT.ADJUSTMENT-IND is equal to one of the following: '0', '5', '6', then CLAIM-HEADER-RECORD-LT has a null value for ICN-ADJ'
Rule Definition If a segment is an LT claim header and has an adjustment indicator that is an original claim/encounter payment, a credit gross adjustment or a debit gross adjustment, then icn adj is not populated.
Denominator Logic # of LT claim headers with CLAIM-HEADER-RECORD-LT.ADJUSTMENT-IND equal to '0', '5', '6'