08/21/2020
|
2.4.0 |
RULE-1656
|
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-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '127', '131', '134', '135', '136', '137', '138', '139', '140', '141', '142', '143', '144'' |
06/19/2020
|
2.4.0 |
RULE-1656
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '131', '134', '135', '136', '137'' |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '127','131', '134', '135', '136', '137', '138', '139', '140', '141', '142', '143', '144'" |
04/17/2020
|
2.4.0 |
RULE-1656
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '087', '088', '089', '115', '119', '120', '121', '122', '131', '134', '135'' |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '087', '088', '089', '115', '119', '120', '121', '122', '131', '134', '135','136','137'' |
09/03/2021
|
3.0.0 |
RULE-1656
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '127', '131', '134', '135', '136', '137', '138', '139', '140', '141', '142', '143', '144' |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', ‘030', ‘031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '127', '131', '134', '135', '136', '137', '138', '139', '140', '141', '142', '143', '144', '147’ |
12/17/2021
|
3.0.0 |
RULE-1656
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', '030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '127', '131', '134', '135', '136', '137', '138', '139', '140', '141', '142', '143', '144', '147'' |
if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT has a valid, non-null value for TYPE-OF-SERVICE and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE is equal to one of the following: '002', '003', '004', '005', '006', '007', '008', '010', '011', '012', '013', '014', '015', '016', '017', '018', '019', '020', '021', '022', '023', '024', '025', '026', '027', '028', '029', ‘030', '031', '032', '035', '036', '037', '038', '039', '040', '041', '042', '043', '049', '050', '051', '052', '053', '054', '055', '056', '057', '058', '060', '061', '062', '063', '064', '065', '066', '067', '068', '069', '070', '071', '072', '073', '074', '075', '076', '077', '078', '079', '080', '081', '082', '083', '084', '085', '086', '087', '088', '089', '115', '119', '120', '121', '122', '127', '131', '134', '135', '136', '137', '138', '139', '140', '141', '142', '143', '144', '145’,'147'' |