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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-2126

Validation Rule
Last updated

Tier 1.1
Tier Description Value Error
Error Category E1103
Error Category Message Value not in specified valid value set
Rule Type Valid Value
File Segment Number ELG00005
Data Element Name ELIGIBILITY-DETERMINANTS.DUAL-ELIGIBLE-CODE
Validation Logic 'If the DUAL-ELIGIBLE-CODE field is populated, the value must be contained in the set of valid values with id: 'DUAL-ELIGIBLE-CODE' and (if ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE is non-null then ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE >= Valid Values Effective-Date and ELIGIBILITY-DETERMINANTS.ELIGIBILITY-DETERMINANT-EFF-DATE <= Valid Values End-Date)'
Rule Definition If dual eligible code is populated on an eligibility determinants segment from an ELG file, then the dual eligible code value reported must be in the list of valid values for dual eligible code.
Denominator Logic # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS.DUAL-ELIGIBLE-CODE equal to a valid, non-null value