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NetworX event codes

Updated on August 31, 2021

The NetworX pricer includes in the XML response file greater than 130 routing codes. Several of the NetworX routing codes have been mapped to discrete Smart Claims Engine event codes. The remaining NetworX outing codes may be mapped to existing or newly created event and/or action codes, which may then be configured to meet the customer’s specific event management needs.

The following routing codes have been mapped to Smart Claims Engine event codes for use in the pricing module. The MapSANPErrorResponseToEvent decision table manages this conversion:

NetworX routing codeSCE event codeSCE event code name
6SSP-0001The claim was re-priced correctly, but is a duplicate of another claim.
23SSP-0003The ICD procedure code on the claim line is missing or is not found in the pricing system.
24SSP-0004The procedure code on the claim line is missing or is not found in the pricing system.
402SSP-0005The diagnosis code is missing or is not found in the pricing system.
403SSP-0006The ICD procedure code on the claim line is missing or is not found in the pricing system.
404SSP-0007The procedure code on the claim line is missing or is not found in the pricing system.
405SSP-0008The HCPCS code on the claim line is missing or is not found in the pricing system.
413SSP-0009No allowed amount is populated on the claim line; manual entry required.
145SSP-0011No valid provider contract was found due to missing mandatory fields on the response.
152SSP-0012No provider could be identified.
154SSP-0013The custom identification code assigned to the provider is not valid.
161SSP-0014Multiple matching or conflicting rate sheets was found.
162SSP-0015No rate sheet matching the claim line date of service was found.

The NetworX pricer application also includes NetworXErrors level error codes to indicate when the XML request file contains formatting errors. These errors are categorized into (a) data format errors, (b) missing data errors, and (c) authorization errors. These NetworXError level errors have been mapped to the following event codes:

SCE event codeSCE event code name
SSP-0016One or more data format errors exist on the claim.
SSP-0017One or more data errors were found, or the claim is missing required data.
SSP-0018One or more errors related to the claim authorization were found.
SSP-0019The Networx Pricer pricing system was not found.
SSP-0020The Networx Pricer pricing system did not respond.

The application validates the presence of several properties in the NetworX XML response file and uses the following single event code when one or several of those properties are missing from the response.

SCE event codeSCE event code name
SSP-0010One or more properties that are required on the external pricer response are missing

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