09/11/2020
|
2.4.0 |
RULE-7391
|
ADD |
Data Dictionary - Validation Rules |
N/A |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to 'D' and CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is not equal to '1' and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE' |
01/27/2021
|
3.0.0 |
RULE-7391
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to 'D' and CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is not equal to '1' and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE' |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D' and CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is not equal to '1' and CLAIM-HEADER-RECORD-RX has a non-null, and not invalidly formatted value for SERVICE-TRACKING-PAYMENT-AMT and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-LINE-RECORD-RX.CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT is equal to '02' then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE |
12/04/2020
|
2.4.0 |
RULE-7391
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to 'D' and CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is not equal to '1' and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE' |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D' and CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is not equal to '1' and CLAIM-HEADER-RECORD-RX has a non-null, and not invalidly formatted value for SERVICE-TRACKING-PAYMENT-AMT and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-LINE-RECORD-RX.CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT is equal to '02' then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE |
04/30/2021
|
3.0.0 |
RULE-7391
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2'and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0'and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686'and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D'and CLAIM-HEADER-RECORD-RX has a non-null, and not invalidly formatted value for SERVICE-TRACKING-PAYMENT-AMTand CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686'and CLAIM-LINE-RECORD-RX.CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT is equal to '02'then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2'and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0'and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654'and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D'and CLAIM-HEADER-RECORD-RX has a non-null, and not invalidly formatted value for SERVICE-TRACKING-PAYMENT-AMTand CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654'and CLAIM-LINE-RECORD-RX.CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT is equal to '02'then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE |
07/02/2021
|
3.0.0 |
RULE-7391
|
UPDATE |
Data Dictionary - Validation Rules |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D' and CLAIM-HEADER-RECORD-RX has a non-null and not invalidly formatted value for SERVICE-TRACKING-PAYMENT-AMT and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654' and CLAIM-LINE-RECORD-RX.CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT equals '02', then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE' |
if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-RX.CLAIM-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '4', 'D' and CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND is not equal to '1' and CLAIM-HEADER-RECORD-RX has a non-null, and not invalidly formatted value for SERVICE-TRACKING-PAYMENT-AMT and CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is not equal to one of the following: '26','026','87','087','542','585', '654', '686' and CLAIM-LINE-RECORD-RX.CMS-64-CATEGORY-FOR-FEDERAL-REIMBURSEMENT is equal to '02' then CLAIM-LINE-RECORD-RX has a non-null value for XXI-MBESCBES-CATEGORY-OF-SERVICE |