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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1

Validation Rule
Last updated

No Updates

Tier 3.0
Tier Description Relational error
Error Category E3002
Error Category Message Values inconsistently specified (multiple record types, multi file)
Rule Type Two Record Type (1 to 1)
File Segment Number ELG00002
Data Element Name PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH • CLAIM-HEADER-RECORD-IP.PROCEDURE-CODE-DATE-1
Validation Logic 'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and PRIMARY-DEMOGRAPHICS-ELIGIBILITY has a valid, non-null value for DATE-OF-DEATH and CLAIM-HEADER-RECORD-IP has a valid, non-null value for PROCEDURE-CODE-DATE-1, then CLAIM-HEADER-RECORD-IP.PROCEDURE-CODE-DATE-1 is less than or equal to PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH'
Rule Definition If a claim is a non-denied claim from an IP file and the procedure code date 1 is populated, and the primary demographics eligibility date of death is populated then the procedure code date 1 is less than or equal to the date of death.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH equal to a valid, non-null value and with CLAIM-HEADER-RECORD-IP.PROCEDURE-CODE-DATE-1 equal to a valid, non-null value