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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.ICF-IID-DAYS • CLAIM-HEADER-RECORD-LT.BEGINNING-DATE-OF-SERVICE • CLAIM-HEADER-RECORD-LT.ENDING-DATE-OF-SERVICE |
Validation Logic | 'if CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-LT has a valid, non-null value for ICF-IID-DAYS and CLAIM-HEADER-RECORD-LT has a valid, non-null value for BEGINNING-DATE-OF-SERVICE and CLAIM-HEADER-RECORD-LT has a valid, non-null value for ENDING-DATE-OF-SERVICE, then CLAIM-HEADER-RECORD-LT.ICF-IID-DAYS is less than or equal to the number of days between CLAIM-HEADER-RECORD-LT.BEGINNING-DATE-OF-SERVICE and CLAIM-HEADER-RECORD-LT.ENDING-DATE-OF-SERVICE, plus one day' |
Rule Definition | If beginning date of service and ending date of service are populated on a non-denied LT claim, then the ICF-IID days value must be less than or equal to the days between the beginning date of service and ending date of service plus one day. |
Denominator Logic | # of LT claim headers with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-LT.ICF-IID-DAYS equals a valid, non-null value and with CLAIM-HEADER-RECORD-LT. BEGINNING-DATE-OF-SERVICE equals to a valid, non-null value and with CLAIM-HEADER-RECORD-LT.ENDING-DATE-OF-SERVICE equals to a valid, non-null value |