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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1866

Validation Rule
Last updated

No Updates

Tier 2.1
Tier Description Relational error
Error Category E2102
Error Category Message Values inconsistently specified (multi record, single file)
Rule Type Two Record Type (1 to 1)
File Segment Number CRX00002
Data Element Name CLAIM-HEADER-RECORD-RX.DATE-PRESCRIBED • FILE-HEADER-RECORD-RX.END-OF-TIME-PERIOD
Validation Logic 'if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX has a valid, non-null value for DATE-PRESCRIBED and FILE-HEADER-RECORD-RX has a valid, non-null value for END-OF-TIME-PERIOD, then CLAIM-HEADER-RECORD-RX.DATE-PRESCRIBED is less than or equal to FILE-HEADER-RECORD-RX.END-OF-TIME-PERIOD'
Rule Definition If date prescribed is populated on a non-denied RX claim and end of time period is populated on the file header, then the date prescribed value reported must be less than or equal to the end of time period value reported.
Denominator Logic # of RX claim headers with CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-RX.DATE-PRESCRIBED equal to a valid, non-null value and with FILE-HEADER-RECORD-RX.END-OF-TIME-PERIOD equal to a valid, non-null value