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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 | ELG00005 |
Data Element Name | ELIGIBILITY-DETERMINANTS.DUAL-ELIGIBLE-CODE |
Validation Logic | 'if ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equals 'G', then ELIGIBILITY-DETERMINANTS.DUAL-ELIGIBLE-CODE is equal to one of the following: '01', '03', '06'' |
Rule Definition | If the restricted benefits code is equal to 'G' (Medicare Part B-ID ESRD Benefit) on an eligibility determinants segment from an ELG file, then the value for dual eligible code must be one of the following: '01', '03', '06'. |
Denominator Logic | # of ELIGIBILITY-DETERMINANTS segments with ELIGIBILITY-DETERMINANTS.RESTRICTED-BENEFITS-CODE equal to 'G' |