RULE-7521

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Tier	1.1
Tier Description	Missing Value Error
Error Category	E1105
Error Category Message	Data Element Value is Missing
Rule Type	One Record Type (Single Record)
File Segment Number	CIP00002
Data Element Name	CLAIM-HEADER-RECORD-IP.SERVICE-TRACKING-TYPE
Validation Logic	'if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-IP.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654', '686' and CLAIM-HEADER-RECORD-IP.ADJUSTMENT-IND does not equal '1' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM is equal to one of the following: '4', 'D', then CLAIM-HEADER-RECORD-IP has a non-null value for SERVICE-TRACKING-TYPE and CLAIM-HEADER-RECORD-IP.SERVICE-TRACKING-TYPE does not equal '0' and CLAIM-HEADER-RECORD-IP.SERVICE-TRACKING-TYPE does not equal '00''
Rule Definition	If a claim is a non-denied, non-void claim from an IP file and the adjustment indicator is not equal to '1' and the type of claim is equal to '4' or 'D', then the claim must have a value populated for service tracking type and does not equal '0' or '00'.
Denominator Logic	# of IP claim headers with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and with CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR does not equal '0' and with CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM does not equal 'Z' and with CLAIM-HEADER-RECORD-IP.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654', '686' and with CLAIM-HEADER-RECORD-IP.ADJUSTMENT-IND does not equal '1' and with CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM is equal to one of the following: '4', 'D'

Published Date	Data Guide Version	Validation Rule	Action	Field	Before	After
04/09/2021	3.0.0	RULE-7521	ADD	Data Dictionary - Validation Rules	N/A	if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-IP.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654', '686' and CLAIM-HEADER-RECORD-IP.ADJUSTMENT-IND does not equal '1' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM is equal to one of the following: '4', 'D' then CLAIM-HEADER-RECORD-IP has a non-null value for SERVICE-TRACKING-TYPE'
03/11/2022	3.0.0	RULE-7521	UPDATE	Data Dictionary - Validation Rules	if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR does not equal '0' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-IP.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654', '686' and CLAIM-HEADER-RECORD-IP.ADJUSTMENT-IND does not equal '1' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM is equal to one of the following: '4', 'D', then CLAIM-HEADER-RECORD-IP has a non-null value for SERVICE-TRACKING-TYPE'	if CLAIM-HEADER-RECORD-IP.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR does not equal ‘0' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM does not equal 'Z' and CLAIM-HEADER-RECORD-IP.CLAIM-STATUS is not equal to one of the following: '26', '026', '87', '087', '542', '585', '654', '686' and CLAIM-HEADER-RECORD-IP.ADJUSTMENT-IND does not equal '1' and CLAIM-HEADER-RECORD-IP.TYPE-OF-CLAIM is equal to one of the following: '4', 'D', then CLAIM-HEADER-RECORD-IP has a non-null value for SERVICE-TRACKING-TYPE and CLAIM-HEADER-RECORD-IP.SERVICE-TRACKING-TYPE does not equal '0’and CLAIM-HEADER-RECORD-IP.SERVICE-TRACKING-TYPE does not equal '00’