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TMSIS Dataguide Medicaid.gov
Version 3.28.0

RULE-561

Validation Rule
Last updated

Tier 2.0
Tier Description Relational error
Error Category E2001
Error Category Message Values inconsistently specified (single record type, single record)
Rule Type One Record Type (Single Record)
File Segment Number CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.WAIVER-TYPE
Validation Logic 'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP.PROGRAM-TYPE equals '07', then CLAIM-HEADER-RECORD-IP.WAIVER-TYPE is equal to one of the following: '06', '07', '08', '09', '10', '11', '12', '13', '14', '15', '16', '17', '18', '19', '20', '33''
Rule Definition If the program type is HCBS on a non-denied IP file, then the waiver type value must be populated with one of the following waiver types:'06', '07', '08', '09', '10', '11', '12', '13', '14', '15', '16', '17', '18', '19', '20', '33'.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-IP.PROGRAM-TYPE equal to '07