An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1421

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type One Record Type (Single Record)
File Segment Number COT00002
Data Element Name CLAIM-HEADER-RECORD-OT.PLAN-ID-NUMBER
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 PLAN-ID-NUMBER, then CLAIM-HEADER-RECORD-OT.PLAN-ID-NUMBER does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the plan ID number is populated on a non-denied claim from an OT file, then the plan ID number reported must not contain any pipe or asterisk characters.
Denominator Logic # of OT claim headers with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2' AND with CLAIM-HEADER-RECORD-OT.PLAN-ID-NUMBER equal to a valid, non-null value