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TMSIS Dataguide Medicaid.gov
Version 3.36.0

RULE-1458

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.OCCURRENCE-CODE-EFF-DATE-04 • CLAIM-HEADER-RECORD-OT.OCCURRENCE-CODE-END-DATE-04
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 OCCURRENCE-CODE-EFF-DATE-04 and CLAIM-HEADER-RECORD-OT has a valid, non-null value for OCCURRENCE-CODE-END-DATE-04, then CLAIM-HEADER-RECORD-OT.OCCURRENCE-CODE-EFF-DATE-04 is less than or equal to CLAIM-HEADER-RECORD-OT.OCCURRENCE-CODE-END-DATE-04'
Rule Definition If a non-denied OT claim has a value populated for occurrence code effective date 04 and occurrence code end date 04, then occurrence code effective date 04 is less than or equal to occurrence code end date 04.
Denominator Logic # of OT claim headers with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-OT.OCCURRENCE-CODE-EFF-DATE-04 equal to a valid, non-null value and with CLAIM-HEADER-RECORD-OT.OCCURRENCE-CODE-END-DATE-04 equal to a valid, non-null value