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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1355

Validation Rule
Last updated

No Updates

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 COT00002
Data Element Name CLAIM-HEADER-RECORD-OT.ENDING-DATE-OF-SERVICE • CLAIM-HEADER-RECORD-OT.BEGINNING-DATE-OF-SERVICE
Validation Logic 'if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-OT has a valid, non-null value for BEGINNING-DATE-OF-SERVICE and CLAIM-HEADER-RECORD-OT has a valid, non-null value for ENDING-DATE-OF-SERVICE, then CLAIM-HEADER-RECORD-OT.BEGINNING-DATE-OF-SERVICE is less than or equal to CLAIM-HEADER-RECORD-OT.ENDING-DATE-OF-SERVICE'
Rule Definition If the beginning date of service and ending date of service are populated on a non-denied claim from an OT file, then the beginning date of service value reported must be before the ending date of service value reported.
Denominator Logic # of OT claim headers with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2' AND with CLAIM-HEADER-RECORD-OT.BEGINNING-DATE-OF-SERVICE equal to a valid, non-null value AND with CLAIM-HEADER-RECORD-OT. ENDING-DATE-OF-SERVICE equal to a valid, non-null value