Validation edit event codes
Pega Marketing User Guide
The list of validation edits in the Process validation edits (SVE) module is detailed below:
| Event code | Name | Description |
| SVE-0001 | Incorrect ICN length | The length of the entered ICN (Internal Control Number) is not equal to 18 digits. |
| SVE-0002 | Duplicate ICN | The claim ICN is an exact duplicate of an existing claim ICN. |
| SVE-0003 | Invalid PX | The procedure code on the claim line is missing or is not found in the system. |
| SVE-0004 | Invalid dental PX | The dental procedure code on the claim line is missing or is not found in the system. |
| SVE-0005 | PX not active | The date of service does not fall within the effective and end dates for the procedure code billed. This event code applies to dental claims only. |
| SVE-0006 | Invalid tooth number | The tooth number submitted on the claim line is not found in the system. |
| SVE-0007 | Invalid tooth surface | The tooth surface code submitted on the claim line is not found in the system. |
| SVE-0008 | Invalid oral cavity code | The area of oral cavity code submitted on the claim line is not found in the system. |
| SVE-0009 | Invalid missing/extracted tooth number | The tooth number indicated as a missing or extracted tooth is not found in the system. |
| SVE-0010 | Undefined claim process method | The claim processing configuration value of "header" or "detail" has not been set for this claim type. |
| SVE-0011 | Claim submission type not configured | The claim cannot be processed by the system because the claim submission type (new, adjustment/replacement, void/cancel) has not been configured in the system. |
| SVE-0012 | Discharge before admit | The discharge date on the claim is prior to the admission date on the claim. |
| SVE-0013 | Invalid claim identifier | The claim identifier (CH, RP, 31) is missing or is not found in the system. |
| SVE-0014 | Claim is for a future date | The "Service from" and/or "Service to" dates on the claim are the claim submission date. |
| SVE-0015 | Invalid DX | The diagnosis code is missing or is not found in the system. |
| SVE-0016 | Invalid "Service from" date | The claim level "Service from" date is after the "Service from" date on one or more claim lines. |
| SVE-0017 | Invalid "Service to" date | The claim level "Service to" date is before the "Service to" date on one or more claim lines. |
| SVE-0018 | Invalid service dates | The claim level "Service from" date is after the "Service to" date on one or more claim lines. |
| SVE-0019 | Invalid NDC | The NDC (national drug code) on the claim line is not found in the system. |
| SVE-0020 | PX not active | The date of service does not fall within the effective and end dates for the procedure code billed. This event code applies to medical claims only. |
| SVE-0021 | DX not active | One or more dates of service do not fall within the effective and end dates for the principal diagnosis code or other diagnosis code. |
| SVE-0023 | Invalid reason code | The adjustment reason code on the claim line is not found in the system. |
| SVE-0024 | Claim type not configured | The claim cannot be processed by the system because the claim form type (professional, inpatient, outpatient, dental, pharmacy) has not been configured in the system. |
| SVE-0025 | Invalid reason code | The claim level adjustment reason code is not found in the system. |
| SVE-0026 | Paid amount missing | The other payer paid amount for this Medicaid reclamation claim is blank. |
| SVE-0027 | Payer name missing | The other payer name for this Medicaid reclamation claim is blank. |
| SVE-0028 | Invalid revenue code | The revenue code on the claim line is not found in the system. |
| SVE-0029 | PX not found | The principal procedure code or another procedure code submitted on the claim header is not found in the system. |
| SVE-0030 | Tooth number and arch submitted | The claim line was billed with both a tooth number and an arch. |
| SVE-0031 | Tooth number and quadrant submitted | The claim line was billed with both a tooth number and a quadrant. |
| SVE-0032 | Quadrant and arch submitted | The claim line was billed with both a quadrant and an arch. Only one area of the oral cavity may be billed on a service line. |
| SVE-0033 | Tooth number or surface and entire oral cavity submitted | The claim line was billed with a tooth number or surface and the entire area of the oral cavity. |
| SVE-0034 | Quadrant and entire oral cavity submitted | The claim line was billed with both a quadrant and the entire area of the oral cavity. |
| SVE-0035 | Arch and entire oral cavity submitted | The claim line was billed with both an arch and the entire area of the oral cavity. |
| SVE-0038 | COB amount mismatch | The other payer paid amounts on the claim lines do not add up to the claim level other payer paid amount. |
| SVE-0039 | Medicaid paid amount mismatch | The Medicaid paid amounts on the claim lines do not add up to the claim level Medicaid paid amount. |
| SVE-0040 | PX partially active | The procedure code is not active during all dates on the claim line. |
| SVE-0041 | Multiple active PX codes | Multiple versions of the same procedure code are in effect during the dates of service. |
| SVE-0042 | Principal DX partially active | Some dates of service do not fall within the effective and end dates for the principal diagnosis code. |
| SVE-0043 | Multiple active principal DX codes | Multiple versions of the same principal diagnosis code are in effect during the dates of service. |
| SVE-0045 | Invalid other DX | One or more other diagnosis codes are not found in the system. |
| SVE-0046 | Other DX partially active | Some dates of service do not fall within the effective and end dates for one or more other diagnosis codes. |
| SVE-0047 | Multiple active other DX codes | Multiple versions of one or more other diagnosis codes are in effect during the dates of service. |
| SVE-0048 | Other DX not active | The dates of service do not fall within the effective and end dates for one or more other diagnosis codes. |
| SVE-0049 | Invalid admitting DX | The admitting diagnosis code is not found in the system. |
| SVE-0050 | Admitting DX not active | The dates of service do not fall within the effective and end dates for the admitting diagnosis code. |
| SVE-0051 | Admitting DX partially active | Some dates of service do not fall within the effective and end dates for the admitting diagnosis code. |
| SVE-0052 | Multiple active DX codes | Multiple versions of the same admitting diagnosis code are in effect during the dates of service. |
| SVE-0053 | Invalid external cause of injury code | The external cause of injury diagnosis code is not found in the system. |
| SVE-0054 | External cause of injury code not active | The dates of service do not fall within the effective and end dates for the external cause of injury diagnosis code. |
| SVE-0055 | External cause of injury code partially active | Some dates of service do not fall within the effective and end dates for the external cause of injury diagnosis code. |
| SVE-0056 | Multiple active external cause of injury codes | Multiple versions of the same external cause of injury diagnosis code are in effect during the dates of service. |
| SVE-0057 | No units billed | No units were billed on the claim line |
| SVE-0058 | Zero units billed | The claim line service units billed equal zero |
Note: if the event codes are not required in the implementation, please reference the event code configuration section to disable or delete event codes that are not required.
Reference information for the code related validation edits (ICD10, HCPCS, etc.) are loaded into the system and is detailed in the Pega Foundation for Healthcare documentation.
Previous topic Data sources for validations Next topic Code group assignment