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Healthcare code set management

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

Pega Foundation for Healthcare provides the infrastructure to maintain commonly referenced, industry-standard, healthcare code sets to be used by your healthcare enterprise applications. It provides you the ability to upload and maintain your licensed code sets in Pega. It contains pre-configured data tables for many code sets. You can add more code sets based on your business needs.

These code sets are leveraged in Pega Healthcare applications, including Pega Customer Service for Healthcare, Pega Smart Claims Engine, Pega Product Composer System and Pega Care Management. The Foundation’s out-of-the-box code sets include, but are not limited to the following:

  • Current Procedural Terminology codes (CPT)
  • International Classification of Disease (ICD) diagnosis and treatment codes
  • Diagnosis Related Groups (DRGs)
  • Healthcare Common Procedure Coding System (HCPCS)
  • Medical Dictionary for Regulatory Activities (MedDRA) code set

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