Data sources for validations
The SCE performs data validations on the following codes against the appropriate supporting table. Information on populating the tables can be found in the code set management documentation for the Pega Foundation for Healthcare (PFHC).
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The SCE switches between ICD-9 and ICD-10 codes based on the coding format identified on the claim.
Code | Table | Class |
Tooth codes | Pr_PegaHC_Data_ToothCodes | PegaHC-Data-ToothCodes |
ICD-9 Procedure codes | ProcedureCode | PegaHealth-Codes-Data-Procedure-ICD9 |
ICD-10 Procedure codes | ICD10Pcs | PegaHealth-Codes-Data-Procedure-ICD10 |
HCPCS Procedure codes | HCPCS_CODES | PegaHealth-Codes-Data-HCPCS |
CPT Procedure codes | CPT_CODES | PegaHealth-Codes-Data-CPT |
CDT Procedure codes | pr_PegaHealth_Codes_Data_CDT | PegaHealth-Codes-Data-CDT |
Revenue codes | REVENUE_CODES | PegaHealth-Codes-Data-Revenue |
NDC Codes | NDC_PACKAGE | PegaHealth-Codes-Data-NDC-Package |
ICD-9 Diagnosis codes | DIAGNOSIS | PegaHealth-Codes-Data-Diagnosis-ICD9 |
ICD-10 Diagnosis codes | ICD10Dx | PegaHealth-Codes-Data-Diagnosis-ICD10 |
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