RULE-1653

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Tier	1.0
Tier Description	Formatting Error
Error Category	E1001
Error Category Message	Value illegal for specified data type
Rule Type	Parse Rule
File Segment Number	COT00002
Data Element Name	CLAIM-LINE-RECORD-OT.SERVICE-QUANTITY-ACTUAL
Validation Logic	if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654', then Value must be a valid dollar amount that matches the specified T-MSIS picture format: S9(8)V999
Rule Definition	If a claim is a non-denied claim from an OT file, then the claim service quantity actual value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(8)V999.
Denominator Logic	# of OT claim lines with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS not in: '26', '87', '542', '585', '654'

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Published Date	Data Guide Version	Validation Rule	Action	Field	Before	After
06/24/2022	3.0.0	Rule-1653	UPDATE	Data Dictionary - Validation Rules	if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654', then Value must be a valid dollar amount that matches the specified T-MSIS picture format: S9(6)V999	if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654', then Value must be a valid dollar amount that matches the specified T-MSIS picture format: S9(8)V999
06/24/2022	3.0.0	RULE-1653	UPDATE	Data Dictionary - Validation Rules	if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654', then Value must be a valid dollar amount that matches the specified T-MSIS picture format: S9(6)V999	if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654', then Value must be a valid dollar amount that matches the specified T-MSIS picture format: S9(8)V999
08/21/2020	2.4.0	RULE-1653	UPDATE	Data Dictionary - Validation Rules	Rule only triggered on adjustment claim lines, not on original claims.	Rules will also be triggered on original claim lines and ADJUSTMENT-IND and LINE-ADJUSTMENT-IND will be used to join claim headers and claim lines for the purpose of applying line-level validation rules. if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654', then Value must be a valid dollar amount that matches the specified T-MSIS picture format: S9(6)V999