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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1683

Validation Rule
Last updated

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type Two Record Type (1 to 1)
File Segment Number COT00002
Data Element Name CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN1
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' and CLAIM-LINE-RECORD-OT has a valid, non-null value for DESTINATION-ADDR-LN1, then CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN1 does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the destination address line 1 is populated on a non-denied claim line from an OT file, then the destination address line 1 reported must not contain any pipe or asterisk characters.
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' and with CLAIM-LINE-RECORD-OT.DESTINATION-ADDR-LN1 equal to a valid, non-null value