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TMSIS Dataguide Medicaid.gov
Version 3.38.0

RULE-782

Validation Rule
Last updated

Tier 2.1
Tier Description Relational error
Error Category E2102
Error Category Message Values inconsistently specified (multi record, single file)
Rule Type Two Record Type (1 to 1)
File Segment Number CIP00002
Data Element Name CLAIM-LINE-RECORD-IP.BEGINNING-DATE-OF-SERVICE • CLAIM-LINE-RECORD-IP.ENDING-DATE-OF-SERVICE
Validation Logic 'if CLAIM-LINE-RECORD-IP.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-IP has a valid, non-null value for BEGINNING-DATE-OF-SERVICE and CLAIM-LINE-RECORD-IP has a valid, non-null value for ENDING-DATE-OF-SERVICE and CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-IP.BEGINNING-DATE-OF-SERVICE is less than or equal to CLAIM-LINE-RECORD-IP.ENDING-DATE-OF-SERVICE'
Rule Definition If beginning date of service and ending date of service are populated on a non-denied claim line from an IP file, then the beginning date of service value reported must be before or equal to the ending date of service value reported.
Denominator Logic # of IP claim lines with CLAIM-LINE-RECORD-IP.CLAIM-LINE-STATUS not in: '26', '87', '542', '585', '654' AND with CLAIM-LINE-RECORD-IP.BEGINNING-DATE-OF-SERVICE equal to a valid, non-null value AND with CLAIM-LINE-RECORD-IP.ENDING-DATE-OF-SERVICE equal to a valid, non-null value AND with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2'