Type 5 Validation Methods

The Pack for Healthcare supports two methods of Type 5 Validation, Code Value and Pattern Match. The choice of validation method is generally determined by the requirements of your organization, the nature of the code list, and access to code list contents.

The hipaa_X12_qualifier.json file contains Type 5 rules that can be checked. These rules will have a validation type of T5, with syntax “ValidationType”: “T5”. Each Type 5 rule also has additional attributes to indicate what method of Type 5 validation to use, and which code table to reference or which pattern to match.

The Code Value method, with "ValidationSubType": "CV", checks that the data content selected for Type 5 validation is present in a particular code list. The Code Table ID, or "CodeTableID" is used to specify the Code List collection that contains the list of all acceptable code items. An example is "CodeTableID" : "T5_022". This method also includes the option to define start and/ or end dates for individual code list items. The transaction processing date is used to determine whether the code item falls within the effective date restrictions.