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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-7976

Validation Rule
Last updated

Tier 2.1
Tier Description Relational error
Error Category E2102
Error Category Message Values inconsistently specified (multi record, single file)
Rule Type Two Record Type (1 to Many)
File Segment Number CIP00002
Data Element Name CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR
Validation Logic 'if all CLAIM-LINE-RECORD-IP.CLAIM-LINE-STATUS is equal to one of the following: '26', '87', '542', '585', '654', then CLAIM-HEADER-RECORD-IP.CLAIM-DENIED-INDICATOR equals '0''
Rule Definition All denied, IP claim line records must have a corresponding claim header record with a claim denied indicator equal to '0' (Denied).
Denominator Logic # of IP claim lines with all CLAIM-LINE-RECORD-IP.CLAIM-LINE-STATUS is equal to one of the following: '26', '87', '542', '585', '654'