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.
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-LINE-RECORD-RX.MSIS-IDENTIFICATION-NUM |
Validation Logic | 'if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D', 'X' and CLAIM-LINE-RECORD-RX has a valid, non-null value for MSIS-IDENTIFICATION-NUM, then CLAIM-LINE-RECORD-RX.MSIS-IDENTIFICATION-NUM starts with the '&' symbol' |
Rule Definition | If MSIS identification number is populated on a non-denied claim line on a service tracking claim from an RX file, then the MSIS identification number reported must start with the '&' (ampersand) symbol. |
Denominator Logic | # of RX claim lines with CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY not equal to 'F2' AND with CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS not in: '26', '87', '542', '585', '654' AND with CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM in: '4', 'D', 'X' AND with CLAIM-LINE-RECORD-RX.MSIS-IDENTIFICATION-NUM equal to a valid, non-null value |