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TMSIS Dataguide Medicaid.gov
Version 3.36.0

RULE-557

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 CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.FUNDING-SOURCE-NONFEDERAL-SHARE
Validation Logic 'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2', then If the field is populated, the value must be contained in the set of valid values with id: 'FUNDING-SOURCE-NONFEDERAL-SHARE' and (if CLAIM-HEADER-RECORD-IP.DISCHARGE-DATE is non-null then CLAIM-HEADER-RECORD-IP.DISCHARGE-DATE is >= Valid Values Effective-Date and <= Valid Values End-Date, else if CLAIM-HEADER-RECORD-IP.ADMISSION-DATE is non-null then CLAIM-HEADER-RECORD-IP.ADMISSION-DATE >= Valid Values Effective-Date and CLAIM-HEADER-RECORD-IP.ADMISSION-DATE <= Valid Values End-Date)'
Rule Definition If the funding source non-federal share is populated on a non-denied claim from an IP file, then the funding source non-federal share reported must be found in the list of valid values.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-IP.FUNDING-SOURCE-NONFEDERAL-SHARE equal to a valid, non-null value