C112 C112.2 SERVICE CODE Conditional If Payment Type Code (C100) is REJECT Payment type code is equal to equal to [05, 06, 08,09] a [payment type code desc] and service code is required, cannot therefore a service code is be NULL required. C113 C113.2 SERVICE DATE Conditional If Payment Type Code (C100) is REJECT [Payment Type Code Desc] to [05, 06, 07, 08, 09] a requires a service date service date is required. C113 C113.6 SERVICE DATE Conditional C113 Service Date must be REJECT Service Date is less the Date of greater than or equal to the Occurrence for the claim (C048) Date of Occurrence C113 C113.7 SERVICE DATE Conditional If C057 Date Finalised is REJECT Service Date is greater than >C059 Date Reopened or C059 the Date Finalised for the Date Reopened is null then claim C113 Service Date must be <= C057 Date Claim Finalised. C113 C113.8 SERVICE DATE Conditional C113 Service Date must be less REJECT Service Date is greater than than or equal to transaction the transaction date for the date payment Payment Mandatory Rules Data Rule Field Name Condition Rule Record Error Message Element No State when fail C099 C099.M INSURER PAYMENT ID Mandatory Mandatory REJECT INSURER PAYMENT ID is a mandatory field C100 C100.M PAYMENT TYPE CODE Mandatory Mandatory field REJECT PAYMENT TYPE CODE is a mandatory field C106 C106.M TRANSACTION DATE Mandatory Mandatory field REJECT TRANSACTION DATE is a mandatory field
C112 C112.2 SERVICE CODE Conditional If Payment Type Code (C100) is equal to [05, 06, 08,09] a service code is required, cannot be NULL REJECT Payment type code is equal to [payment type code desc] and therefore a service code is required. C113 C113.2 SERVICE DATE Conditional If Payment Type Code (C100) is to [05, 06, 07, 08, 09] a service date is required. REJECT [Payment Type Code Desc] requires a service date C113 C113.6 SERVICE DATE Conditional C113 Service Date must be greater than or equal to the (C048) Date of Occurrence REJECT Service Date is less the Date of Occurrence for the claim C113 C113.7 SERVICE DATE Conditional If C057 Date Finalised is >C059 Date Reopened or C059 Date Reopened is null then C113 Service Date must be <= C057 Date Claim Finalised. REJECT Service Date is greater than the Date Finalised for the claim C113 C113.8 SERVICE DATE Conditional C113 Service Date must be less than or equal to transaction date REJECT Service Date is greater than the transaction date for the payment Payment Mandatory Rules Data Element Rule No Field Name Condition Rule Record State when fail Error Message C099 C099.M INSURER PAYMENT ID Mandatory Mandatory REJECT INSURER PAYMENT ID is a mandatory field C100 C100.M PAYMENT TYPE CODE Mandatory Mandatory field REJECT PAYMENT TYPE CODE is a mandatory field C106 C106.M TRANSACTION DATE Mandatory Mandatory field REJECT TRANSACTION DATE is a mandatory field
NIDS_V_8.0.docx