An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-934

Validation Rule
Last updated

No Updates

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 1)
File Segment Number CLT00002
Data Element Name CLAIM-HEADER-RECORD-LT.BEGINNING-DATE-OF-SERVICE • FILE-HEADER-RECORD-LT.END-OF-TIME-PERIOD
Validation Logic 'if CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-LT.TYPE-OF-CLAIM is not equal to one of the following: '2', 'B', 'V' and CLAIM-HEADER-RECORD-LT has a valid, non-null value for BEGINNING-DATE-OF-SERVICE and FILE-HEADER-RECORD-LT has a valid, non-null value for END-OF-TIME-PERIOD, then CLAIM-HEADER-RECORD-LT.BEGINNING-DATE-OF-SERVICE is less than or equal to FILE-HEADER-RECORD-LT.END-OF-TIME-PERIOD'
Rule Definition If beginning date of service is populated on a non-denied claim from an LT file that is not a Medicaid or Medicaid-expansion, S-CHIP, or other Capitated Payment and end of time period is populated on the file header, then the beginning date of service value reported must be before or equal to the end of time period value reported.
Denominator Logic # of LT claims with CLAIM-HEADER-RECORD-LT.CLAIM-STATUS-CATEGORY not equal to 'F2' AND with CLAIM-HEADER-RECORD-LT.TYPE-OF-CLAIM not in: '2', 'B', 'V' AND with CLAIM-HEADER-RECORD-LT.BEGINNING-DATE-OF-SERVICE equal to a valid, non-null value AND with FILE-HEADER-RECORD-LT.END-OF-TIME-PERIOD equal to a valid, non-null value