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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 | CRX00002 |
Data Element Name | CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR |
Validation Logic | 'if all CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is equal to one of the following: '26', '87', '542', '585', '654', then CLAIM-HEADER-RECORD-RX.CLAIM-DENIED-INDICATOR equals '0'' |
Rule Definition | All denied, RX claim line records must have a corresponding claim header record with a claim denied indicator equal to '0' (Denied). |
Denominator Logic | # of RX claim lines with all CLAIM-LINE-RECORD-RX.CLAIM-LINE-STATUS is equal to one of the following: '26', '87', '542', '585', '654' |