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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1777

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 CRX00002
Data Element Name CLAIM-HEADER-RECORD-RX.CLAIM-PYMT-REM-CODE-1 • CLAIM-HEADER-RECORD-RX.CLAIM-PYMT-REM-CODE-2 • CLAIM-HEADER-RECORD-RX.CLAIM-PYMT-REM-CODE-3 • CLAIM-HEADER-RECORD-RX.CLAIM-PYMT-REM-CODE-4
Validation Logic 'if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2', then The values of the following fields should be unique for each CLAIM-HEADER-RECORD-RX record: CLAIM-PYMT-REM-CODE-1, CLAIM-PYMT-REM-CODE-2, CLAIM-PYMT-REM-CODE-3, CLAIM-PYMT-REM-CODE-4'
Rule Definition If more than one CLAIM-PYMT-REM-CODE is submitted on a non-denied RX claim, then the values must be unique.
Denominator Logic # of RX claim headers with CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY not equal to 'F2'