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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 | COT00002 |
Data Element Name | CLAIM-HEADER-RECORD-OT.ADJUSTMENT-IND |
Validation Logic | 'if CLAIM-HEADER-RECORD-OT has a null value for ICN-ADJ, then CLAIM-HEADER-RECORD-OT.ADJUSTMENT-IND is equal to one of the following: '0', '5', '6'' |
Rule Definition | If a segment is an OT claim header and icn adj is not populated, then the adjustment indicator is an original claim/encounter payment, credit gross adjustment or a debit gross adjustment payment. |
Denominator Logic | # of OT claim headers with CLAIM-HEADER-RECORD-OT.ICN-ADj having a null value |