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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-7296

Validation Rule
Last updated

Tier 2.0
Tier Description Relational error
Error Category E2002
Error Category Message Values inconsistently specified (single record type, multiple records)
Rule Type Two Record Type (1 to 1)
File Segment Number COT00002
Data Element Name CLAIM-HEADER-RECORD-OT.HEALTH-HOME-ENTITY-NAME
Validation Logic 'if CLAIM-HEADER-RECORD-OT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-OT.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-OT.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-OT.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654', '686' and CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is not equal to one of the following: '26', '87', '542', '585', '654' and CLAIM-LINE-RECORD-OT.TYPE-OF-SERVICE equals '138', then CLAIM-HEADER-RECORD-OT has a non-null value for HEALTH-HOME-ENTITY-NAME'
Rule Definition
Denominator Logic