An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1865

Validation Rule
Last updated

No Updates

Tier 3.0
Tier Description Relational error
Error Category E3002
Error Category Message Values inconsistently specified (multiple record types, multi file)
Rule Type Two Record Type (1 to 1)
File Segment Number ELG00002
Data Element Name PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH • CLAIM-HEADER-RECORD-RX.DATE-PRESCRIBED
Validation Logic 'if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and PRIMARY-DEMOGRAPHICS-ELIGIBILITY has a valid, non-null value for DATE-OF-DEATH and CLAIM-HEADER-RECORD-RX has a valid, non-null value for DATE-PRESCRIBED, then CLAIM-HEADER-RECORD-RX.DATE-PRESCRIBED is less than or equal to PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH'
Rule Definition If a non-denied RX claim has a value populated for date prescribed and the date of death is populated on the primary demographics eligibility segment, then the date prescribed must be less than or equal to the date of death.
Denominator Logic # of RX claim headers with CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY not equal to 'F2' and PRIMARY-DEMOGRAPHICS-ELIGIBILITY.DATE-OF-DEATH equal to a valid, non-null value and CLAIM-HEADER-RECORD-RX.DATE-PRESCRIBED equal to a valid, non-null value