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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-6199

Validation Rule
Last updated

No Updates

Tier 1.0
Tier Description Formatting Error
Error Category E1001
Error Category Message Value illegal for specified data type
Rule Type Parse Rule
File Segment Number COT00002
Data Element Name CLAIM-HEADER-RECORD-OT.DIAGNOSIS-CODE-FLAG-1
Validation Logic if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2', then Value must be compatible with specified T-MSIS picture format: X(1)
Rule Definition If a claim is a non-denied claim from an OT file, then the diagnosis code flag 1 value reported must be compatible with specified T-MSIS picture format: X(1).
Denominator Logic # of OT claim headers with CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY not equal to 'F2'