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TMSIS Dataguide Medicaid.gov
Version 3.36.0

RULE-674

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type One Record Type (Single Record)
File Segment Number CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.ELIGIBLE-MIDDLE-INIT
Validation Logic 'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP has a valid, non-null value for ELIGIBLE-MIDDLE-INIT, then CLAIM-HEADER-RECORD-IP.ELIGIBLE-MIDDLE-INIT does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the eligible middle initial is populated on a non-denied claim from an IP file, then the eligible middle initial reported must not contain any pipe or asterisk characters.
Denominator Logic # of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-IP.ELIGIBLE-MIDDLE-INIT equal to a valid, non-null value