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Validation edit event codes

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Updated on August 31, 2021

The list of validation edits in the Process validation edits (SVE) module is detailed below:

Event codeNameDescription
SVE-0001Incorrect ICN lengthThe length of the entered ICN (Internal Control Number) is not equal to 18 digits.
SVE-0002Duplicate ICNThe claim ICN is an exact duplicate of an existing claim ICN.
SVE-0003Invalid PXThe procedure code on the claim line is missing or is not found in the system.
SVE-0004Invalid dental PXThe dental procedure code on the claim line is missing or is not found in the system.
SVE-0005PX not activeThe 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-0006Invalid tooth numberThe tooth number submitted on the claim line is not found in the system.
SVE-0007Invalid tooth surfaceThe tooth surface code submitted on the claim line is not found in the system.
SVE-0008Invalid oral cavity codeThe area of oral cavity code submitted on the claim line is not found in the system.
SVE-0009Invalid missing/extracted tooth numberThe tooth number indicated as a missing or extracted tooth is not found in the system.
SVE-0010Undefined claim process methodThe claim processing configuration value of "header" or "detail" has not been set for this claim type.
SVE-0011Claim submission type not configuredThe 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-0012Discharge before admitThe discharge date on the claim is prior to the admission date on the claim.
SVE-0013Invalid claim identifierThe claim identifier (CH, RP, 31) is missing or is not found in the system.
SVE-0014Claim is for a future dateThe "Service from" and/or "Service to" dates on the claim are before the claim submission date.
SVE-0015Invalid DXThe diagnosis code is missing or is not found in the system.
SVE-0016Invalid "Service from" dateThe claim level "Service from" date is after the "Service from" date on one or more claim lines.
SVE-0017Invalid "Service to" dateThe claim level "Service to" date is before the "Service to" date on one or more claim lines.
SVE-0018Invalid service datesThe claim level "Service from" date is after the "Service to" date on one or more claim lines.
SVE-0019Invalid NDCThe NDC (national drug code) on the claim line is not found in the system.
SVE-0020PX not activeThe 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-0021DX not activeOne or more dates of service do not fall within the effective and end dates for the principal diagnosis code or other diagnosis code.
SVE-0023Invalid reason codeThe adjustment reason code on the claim line is not found in the system.
SVE-0024Claim type not configuredThe 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-0025Invalid reason codeThe claim level adjustment reason code is not found in the system.
SVE-0026Paid amount missingThe other payer paid amount for this Medicaid reclamation claim is blank.
SVE-0027Payer name missingThe other payer name for this Medicaid reclamation claim is blank.
SVE-0028Invalid revenue codeThe revenue code on the claim line is not found in the system.
SVE-0029PX not foundThe principal procedure code or another procedure code submitted on the claim header is not found in the system.
SVE-0030Tooth number and arch submittedThe claim line was billed with both a tooth number and an arch.
SVE-0031Tooth number and quadrant submittedThe claim line was billed with both a tooth number and a quadrant.
SVE-0032Quadrant and arch submittedThe 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-0033Tooth number or surface and entire oral cavity submittedThe claim line was billed with a tooth number or surface and the entire area of the oral cavity.
SVE-0034Quadrant and entire oral cavity submittedThe claim line was billed with both a quadrant and the entire area of the oral cavity.
SVE-0035Arch and entire oral cavity submittedThe claim line was billed with both an arch and the entire area of the oral cavity.
SVE-0038COB amount mismatchThe other payer paid amounts on the claim lines do not add up to the claim level other payer paid amount.
SVE-0039Medicaid paid amount mismatchThe Medicaid paid amounts on the claim lines do not add up to the claim level Medicaid paid amount.
SVE-0040PX partially activeThe procedure code is not active during all dates on the claim line.
SVE-0041Multiple active PX codesMultiple versions of the same procedure code are in effect during the dates of service.
SVE-0042Principal DX partially activeSome dates of service do not fall within the effective and end dates for the principal diagnosis code.
SVE-0043Multiple active principal DX codesMultiple versions of the same principal diagnosis code are in effect during the dates of service.
SVE-0045Invalid other DXOne or more other diagnosis codes are not found in the system.
SVE-0046Other DX partially activeSome dates of service do not fall within the effective and end dates for one or more other diagnosis codes.
SVE-0047Multiple active other DX codesMultiple versions of one or more other diagnosis codes are in effect during the dates of service.
SVE-0048Other DX not activeThe dates of service do not fall within the effective and end dates for one or more other diagnosis codes.
SVE-0049Invalid admitting DXThe admitting diagnosis code is not found in the system.
SVE-0050Admitting DX not activeThe dates of service do not fall within the effective and end dates for the admitting diagnosis code.
SVE-0051Admitting DX partially activeSome dates of service do not fall within the effective and end dates for the admitting diagnosis code.
SVE-0052Multiple active DX codesMultiple versions of the same admitting diagnosis code are in effect during the dates of service.
SVE-0053Invalid external cause of injury codeThe external cause of injury diagnosis code is not found in the system.
SVE-0054External cause of injury code not activeThe dates of service do not fall within the effective and end dates for the external cause of injury diagnosis code.
SVE-0055External cause of injury code partially activeSome dates of service do not fall within the effective and end dates for the external cause of injury diagnosis code.
SVE-0056Multiple active external cause of injury codesMultiple versions of the same external cause of injury diagnosis code are in effect during the dates of service.
SVE-0057No units billedNo units were billed on the claim line
SVE-0058Zero units billedThe 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 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.

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