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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 | COT00003 |
Data Element Name | CLAIM-LINE-RECORD-OT.MEDICAID-PAID-AMT |
Validation Logic | 'if CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is equal to one of the following: '26', '026', '87', '087', '542', '585', '654', then CLAIM-LINE-RECORD-OT has a null value for MEDICAID-PAID-AMT or CLAIM-LINE-RECORD-OT.MEDICAID-PAID-AMT equals '0.00'' |
Rule Definition | If an OT claim line is for a denied claim, then the medicaid paid amount has a missing or zero value. |
Denominator Logic | # of OT claim lines with CLAIM-LINE-RECORD-OT.CLAIM-LINE-STATUS is equal to one of the following: '26', '026', '87', '087', '542', '585', '654' |