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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 | CRX00002 |
Data Element Name | CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND |
Validation Logic | 'if CLAIM-HEADER-RECORD-RX has a non-null value for ICN-ADJ, then CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is equal to one of the following: '4', '1'' |
Rule Definition | If a segment is an RX claim header and icn adj is populated, then adjustment indicator is a replacement or resubmission payment or a void, reversal or canceled payment. |
Denominator Logic | # of RX claim headers with CLAIM-HEADER-RECORD-RX.ICN-ADj having a non-null value |