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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-2928

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 PRV00006
Data Element Name PROV-TAXONOMY-CLASSIFICATION.PROV-TAXONOMY-CLASSIFICATION-EFF-DATE • PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-CODE • PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-TYPE
Validation Logic 'if PROV-TAXONOMY-CLASSIFICATION has a valid, non-null value for PROV-CLASSIFICATION-TYPE and PROV-TAXONOMY-CLASSIFICATION has a valid, non-null value for PROV-CLASSIFICATION-CODE, then if PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-TYPE is '1' then PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-CODE is a valid value in 'PROV-CLASSIFICATION-CODE-TYPE-1' on the date specified by PROV-TAXONOMY-CLASSIFICATION.PROV-TAXONOMY-CLASSIFICATION-EFF-DATE. If PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-TYPE is '2' then PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-CODE is a valid value in 'PROV-SPECIALTY' on the date specified by PROV-TAXONOMY-CLASSIFICATION.PROV-TAXONOMY-CLASSIFICATION-EFF-DATE. If PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-TYPE is '3' then PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-CODE is a valid value in 'PROV-TYPE' on the date specified by PROV-TAXONOMY-CLASSIFICATION.PROV-TAXONOMY-CLASSIFICATION-EFF-DATE. If PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-TYPE is '4' then PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-CODE is a valid value in 'PROV-CLASSIFICATION-CODE-TYPE-4' on the date specified by PROV-TAXONOMY-CLASSIFICATION.PROV-TAXONOMY-CLASSIFICATION-EFF-DATE.'
Rule Definition If provider classification type and provider classification code are populated on a provider taxonomy classification segment from a PRV file, then the provider classification code value reported must be in the list of valid values corresponding to the provider classification type on the date specified by the provider taxonomy classification effective date.
Denominator Logic # of PROV-TAXONOMY-CLASSIFICATION segments with PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-TYPE equal to a valid, non-null value AND with PROV-TAXONOMY-CLASSIFICATION.PROV-CLASSIFICATION-CODE equal to a valid, non-null value