ICD Codes Correction Profile Workflow

The profile validates an incoming 837 EDI data, splits the data into good and bad claims, and then corrects invalid ICD-10 codes at run time based on the provided crosswalk file.

The crosswalk file contains a sample mapping of invalid (source column) and correct (target column) codes and looks like the following:

Source column	Target column
H5318 Z8952 Z999	H5319 Z89521 Z9989

This crosswalk is used only to demonstrate the profile's operability; you can extend the list of codes for real-life tasks.

The Code Correction route in this profile validates 837 claims and replaces invalid ICD codes with correct values.

Route Structure

Route Components Description

Component Name	Component Type	Description
FS Inbound	FS Inbound	Picks up 837 transactions from the file system. The route assumes that some claims may contain expired, invalid or blank ICD codes.
Native Processing	XE Native	Validates and splits the incoming data into good and bad claims.
Good Claims	FS Outbound	Stores good claims on the file system.
Bad Claims	FS Outbound	Stores bad claims on the file system.
Translator	XE Translator	Converts 837 EDI data into the same data format replacing the invalid ICD codes with the correct ones using the map ICD10correction.ems that is available in the directory ${XESProfileConfig}/configuration/artefacts. The component takes the correct code values from the crosswalk file linked to the map.
Fixed data	FS Outbound	Stores claims with the corrected ICD-10 codes on the file system.