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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 | ELG00011 |
Data Element Name | STATE-PLAN-OPTION-PARTICIPATION.STATE-PLAN-OPTION-TYPE |
Validation Logic | 'if CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY does not equal 'F2' and STATE-PLAN-OPTION-PARTICIPATION has a valid, non-null value for STATE-PLAN-OPTION-TYPE and CLAIM-HEADER-RECORD-LT.PROGRAM-TYPE equals '13', then STATE-PLAN-OPTION-PARTICIPATION.STATE-PLAN-OPTION-TYPE equals '02'' |
Rule Definition | If the program type is HCBS State Plan Option 1915(i) on a non-denied claim from an LT file, then the waiver type value reported must be '2'. |
Denominator Logic | # of LT claim headers with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY is not equal 'F2' and with STATE-PLAN-OPTION-PARTICIPATION.STATE-PLAN-OPTION-TYPE is equal to a valid, non-null value and with CLAIM-HEADER-RECORD-LT.PROGRAM-TYPE equals '13' |