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Healthcare code group management

Updated on April 12, 2021
Pega Foundation for Healthcare Product Overview

The Common Codes management capability in the Foundation includes the ability to create and maintain custom groupings of codes from various code sets to be leveraged in your applications. For example, the code group instances created in this application are used in Pega Product Composer System to define benefits and are also leveraged in Pega Smart Claims Engine for benefit determination during claim adjudication. The Pega Care Management application also leverages code groups to identify gaps in care from historical claims for a member or a population.

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