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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-7650

Validation Rule
Last updated

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 CRX00002
Data Element Name CLAIM-HEADER-RECORD-RX.ADJUSTMENT-IND
Validation Logic 'if CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '3', 'C', then CLAIM-HEADER-RECORD-RX has a non-null value for ADJUSTMENT-IND'
Rule Definition If a segment is an RX claim header, and the type of claim is an encounter, the adjustment indicator must be populated.
Denominator Logic # of RX claim headers with CLAIM-HEADER-RECORD-RX.TYPE-OF-CLAIM is equal to one of the following: '3', 'C'