openapi: 3.2.0
info:
title: Optum Real-Time eContent Web services Code Information API
description: Optum® Real-Time eContent web services provides access to both ondemand medical coding data and Optum coding tool logic required by your applications. The information you or your clients need is delivered to your application in real time, when you need it, and customized to how you want it displayed. Optum Real-Time eContent service provides access to the content of 37 printed coding resources and proprietary data and offers the power of the Optum CodeLogic™ search engine.
contact:
name: Ken Kracker
email: ken.kracker@optum.com
version: 1.0.0
servers:
- url: sandbox-apigw.optum.com/ci/rtec/v1/ws
security:
- bearerAuth: []
tags:
- name: Code Information
paths:
/codetype/{codetype}/{code}/anesbaseunit:
get:
tags:
- Code Information
summary: Return base units for the given CPT Anesthesia {code}
operationId: getAnesBaseUnit
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: '00100'
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
item:
- '5'
'400':
description: Bad Request
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
error:
- The code provided ('A0021') in this web service request is not a valid 'cpt' code.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/{facNonFac}:
get:
tags:
- Code Information
summary: Return code range
operationId: getColumnCci
parameters:
- name: code
in: path
description: The code for which you want CCI data
required: true
schema:
type: string
example: 13100
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- name: facNonFac
in: path
description: One of
- facility-cci
- non-facility-cci
required: true
schema:
type: string
enum:
- facility-cci
- non-facility-cci
- name: data
in: query
description: 'Comma seperated list of- reason : e.g. Anesthesia Included in Surgical Procedure
- modifier-allowed : e.g. true
- modifier-allowed : e.g. true
'
schema:
type: string
example: reason,modifier-allowed
- name: types
in: query
description: 'Comma seperated list of- cci-column2 : procedures that are included
- cci-column1 : procedures in which this is included
- cci-all : All of the above 2 types
'
schema:
type: string
default: cci-all
example: cci-all,cci-column2,cci-column1
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Cci'
example:
cciColumn2:
- code: 0213T
href: /ws/codetype/cpt/0213T
- code: 0216T
href: /ws/codetype/cpt/0216T
cciColumn1: []
'400':
description: Unknown data element
content:
application/json:
schema:
$ref: '#/components/schemas/Cci'
example:
error:
- 'Unknown data element : bad'
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/Cci'
example:
error:
- Code '13104' does not exist
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/codehistory:
get:
tags:
- Code Information
summary: Return Code History for the given cpt/hcpcs/icd9v3/icd9v1/icd10cm/icd10pcs {code}
operationId: getCodehistory
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd9v3
- icd10cm
- icd10pcs
- name: code
in: path
description: The code for which you want CCI data
required: true
schema:
type: string
example: 99213
- name: yyyy-mm-dd
in: header
description: Historical Application Content(HAC) is not applicable here. This Code history webservice accepts Current date or future date only. For Current date, date is optional. For Future date, date must be provided
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/CompleteCodeHistory'
example:
codeHistory:
- changeEffectiveDate: 01/01/2021
status: Changed
changeSummary: Officially recognized, Other, Changed
fullInfo: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter.EST OUTPT L3 EXP PROB H&E LOW COMPLX MED DEC
char48Info:
OFFICEOFC/OUTPATIENT ESTABLISHED LOWOUTPT VISIT E&M EST MDM 20-29MOD SEVERITY 15 MIN
char35Info:
OFFICE OOFC/P EST LOWOUTPT E&M ESTAB 20-29MOD 15 MIN
codeHistoryReferences: {}
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/CompleteCodeHistory'
example:
error:
- The code provided ('250.0') in this web service request is not a valid 'cpt' code.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/CompleteCodeHistory'
example:
error:
- Code '13108' does not exist
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/properties:
get:
tags:
- Code Information
summary: Show properties for the given {codetype} and {code} parameter
operationId: getProperty
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd9v3
- icd10cm
- icd10pcs
- name: code
in: path
description: The code to search
required: true
schema:
type: string
example: 99213
- name: yyyy-mm-dd
in: header
description: The Properties webservice accepts Current date or future date only. For Current date, date is optional. For Future date, date must be provided
schema:
type: string
- name: data
in: query
description: 'Comma seperated list of any of the following
- desc-35 : up to 35 character description (except 3rd or 4th digit ICD-10-PCS)
- desc-48 : up to 48 character description (except 3rd or 4th digit ICD-10-PCS)
- desc-255 : up to 255 character description (except 3rd or 4th digit ICD-10-PCS)
- desc-full : full description
- desc-lay : Lay description (only for cpt/hcpcs/icd9v1/icd10cm)
- coding-tip
- documentation-tip
- reimbursement-tip
'
schema:
type: string
default: desc-full
example: desc-full
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/CodeProperties'
example:
descFull: Central Nervous System and Cranial Nerves, Bypass
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/CodeProperties'
example:
error:
- Bad data parameter 'bad'
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/CodeProperties'
example:
error:
- Code '13104' does not exist
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/images:
get:
tags:
- Code Information
summary: Return image filename(s) for the given code {code}
operationId: getCodeImageLinks
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd9v3
- name: code
in: path
description: The code for which you want Image data
required: true
schema:
type: string
example: 61885
responses:
'200':
description: Successful Response
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/codetype/cpt/61885/images/61885-61886 ATNN.jpg
value: ''
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/images/{filename}:
get:
tags:
- Code Information
summary: Return image(s) for the given code {code}
operationId: getImage
parameters:
- name: filename
in: path
description: The File Name
required: true
schema:
type: string
default: 61885-61886 ATNN.jpg
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd9v3
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: 61885
responses:
'200':
description: Successful Response
content:
image/*:
schema:
$ref: '#/components/schemas/Response'
example: default image response
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}:
get:
tags:
- Code Information
summary: Return links to all the information available about a given 'code' belonging to the given 'codetype'
operationId: getProperties
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd9v3
- icd10cm
- icd10pcs
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 13100
responses:
'200':
description: Successful Response - code 13100 , type - cpt
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/codetype/cpt/13100/icd9v3
value: icd9v3 crosscodes
- href: /ws/codetype/cpt/13100/icd9v1
value: icd9v1 crosscodes
- href: /ws/codetype/cpt/13100/icd10cm
value: icd10cm crosscodes
- href: /ws/codetype/cpt/13100/icd10pcs
value: icd10pcs crosscodes
'400':
description: Wrong Code Type
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
error:
- The code provided ('250.02') in this web service request is not a valid 'cpt' code.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype:
get:
tags:
- Code Information
summary: Show HyperLinks to valid code types
operationId: getCodeTypes
responses:
'200':
description: Successful Response
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/codetype/icd9v3
value: icd9v3
- href: /ws/codetype/icd9v1
value: icd9v1
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/indexsearch/{terms}:
get:
tags:
- Code Information
summary: Return Index search results
operationId: indexSearchResults
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd9v3
- icd10cm
- name: terms
in: path
description: Search Term (Starts with Character) to provide results
required: true
schema:
pattern: '[^/]+'
type: string
example: reduction
- name: maxresults
in: query
description: The number of rows be returned
schema:
type: integer
format: int32
default: 100
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/IndexSearchResults'
example:
indexSearchResult:
- term: Reduction
level: 1
- term: Blood Volume
level: 2
codes: '86960'
'400':
description: The search term can contain maximum of 62 characters
content:
application/json:
schema:
$ref: '#/components/schemas/IndexSearchResults'
example:
error:
- The search term can contain maximum of 62 characters.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: No search results found
content:
application/json:
schema:
$ref: '#/components/schemas/IndexSearchResults'
example:
error: []
warning: []
info:
- No search results found for the term 'xyzfgdf' entered.
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/dictionary/coders/{startswith}:
get:
tags:
- Code Information
summary: Optum Coders Dictionary Search
operationId: searchStedmans
parameters:
- name: startswith
in: path
description: The term to start with
required: true
schema:
type: string
example: diabetes
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/IngenixCodersDictionary'
example:
entry:
- definition: 'Endocrine disease manifested by high blood glucose levels and resulting in the inability to successfully metabolize carbohydrates, proteins, and fats, due to defects in insulin production and secretion, insulin action, or both. Type I results from the autoimmune or other destruction of the pancreatic beta cells, which cease producing insulin. This type is commonly seen at a young age and requires regular insulin injections. Type II is caused by the body''s inability to respond to insulin that is produced, called insulin resistance. The pancreas gradually loses the ability to produce insulin. Type II is usually seen in adulthood and can often be treated with diet, exercise, and oral medications. Type II may also require insulin, however, and is also diagnosed among juvenile patients. Synonym(s): DM.'
icd9: 249, 249.4, 250, 250.4, 581.81, 775.1, 40.1
synonyms: diabetes mellitus hypertension-nephrosis syndrome, diabetes mellitus in newborn infant syndrome
term: diabetes mellitus
- definition: High blood pressure and kidney failure resulting from diabetes in which carbohydrate utilization is reduced and lipid and protein use are enhanced.
icd9: 249.40 - 249.41, 250.40 - 250.43, 581.81
term: diabetes mellitus hypertension-nephrosis syndrome
- definition: Newborn that has the inability to metabolize carbohydrates, proteins, and fats with insufficient secretion of insulin.
icd9: '775.1'
term: diabetes mellitus in newborn infant syndrome
- definition: Educational and training services furnished by a certified provider in an outpatient setting. The physician managing the individual's diabetic condition must certify that the services are needed under a comprehensive plan of care and provide the patient with the skills and knowledge necessary for therapeutic program compliance (including skills related to the self-administration of injectable drugs). The provider must meet applicable standards established by the National Diabetes Advisory or be recognized by an organization that represents individuals with diabetes as meeting standards for furnishing the services.
term: diabetes outpatient self-management training services
- definition: Endocrine dysfunction causing diabetes and affecting growth and weight.
icd9: '258.1'
term: diabetes-dwarfism-obesity syndrome
- definition: High blood pressure and kidney failure resulting from diabetes in which carbohydrate utilization is reduced and lipid and protein use are enhanced.
icd9: 249.40, 249.40 - 249.41, 249.41, 250.40 - 250.43, 250.41, 250.42, 250.43, 581.81
term: diabetes-nephrosis syndrome
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/instructional-notes:
get:
tags:
- Code Information
summary: Return instructional Notes for the given icd9v1 {code}
operationId: getInstructions
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
pattern: icd9v1
type: string
example: icd9v1
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 295
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/InstructionalNotes'
example:
instructionalNote:
- header: 5. Mental, Behavioral and Neurodevelopmental Disorders (290-319)
note:
- ~5. MENTAL, BEHAVIORAL AND NEURODEVELOPMENTAL DISORDERS (290-319)
- header: Psychoses (290-299)
note:
- '~PSYCHOSES (290-299)~Excludes: intellectual disabilities (317-319)~'
- header: Other Psychoses (295-299)
note:
- '~PSYCHOSES (290-299)~Excludes: mental retardation (317-319)~OTHER PSYCHOSES (295-299)~Use additional code to identify any associated physical disease, injury, or condition affecting the brain with psychoses classifiable to 295-298'
'400':
description: The provided code is not a valid icd9v1 code
content:
application/json:
schema:
$ref: '#/components/schemas/InstructionalNotes'
example:
error:
- The code provided ('99213') in this web service request is not a valid 'icd9v1' code.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code 'code' does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/InstructionalNotes'
example:
error:
- Code '999.99' does not exist
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/instructions:
get:
tags:
- Code Information
summary: Return instructions for the given cpt {code}
operationId: getInstructions_1
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 99213
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
item:
- 'Excludes Services provided in:'
- Excludes Hospital observation or inpatient with same day admission and discharge (99234-99236)
- Excludes Hospital observation (99217-99220 [99224, 99225, 99226])
- 'Includes New patients: have not received professional services from the physician or qualified health care professional or any other physician or qualified health care professional in the same practice in the exact same specialty and subspecialty in the previous three years (99201-99205)'
- Includes Office visits
- 'Includes Established patients: received prior professional services from the physician or qualified health care professional or another physician or qualified health care professional in the practice of the exact same specialty and subspecialty in the previous three years (99211-99215)'
- Includes Outpatient services (including services prior to a formal admission to a facility)
- Excludes Emergency department (99281-99285)
'400':
description: The provided code is not a valid icd9v1 code
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
error:
- The code provided ('250.0') in this web service request is not a valid 'cpt' code.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code 'code' does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
error:
- Code '13108' does not exist
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/cci-check/{facNonFac}/{codes}:
get:
tags:
- Code Information
summary: Return the billing relationships between the given codes
operationId: getMultiCCIData
parameters:
- name: facNonFac
in: path
description: One of- facility-cci
- non-facility-cci
required: true
schema:
type: string
enum:
- facility-cci
- non-facility-cci
- name: codes
in: path
description: Comma seperated list of codes
required: true
schema:
type: string
example: 99213,13152,11000
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Multicci'
example:
conflict:
- code1:
description: Debridement of extensive eczematous or infected skin; up to 10% of body surface
reason: CPT Manual or CMS manual coding instructions
modifier: Allowed
primarysecondary: Primary
value: '11000'
code2:
description: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of
reason: CPT Manual or CMS manual coding instructions
modifier: Allowed
primarysecondary: Secondary
value: '99213'
name: CCI Conflict Code 11000(Column 1) conflicts with Code 99213(Column 2).
message: 'Warning: These codes may not be billed together. Check to see if a modifier is allowed and supported by documentation'
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Multicci'
example:
error:
- The provided code is not a valid cpt/hcpcs code
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: CCI relationship was not found
content:
application/json:
schema:
$ref: '#/components/schemas/Multicci'
example:
error: []
warning: []
info:
- CCI relationship was not found.
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/sectionnotes:
get:
tags:
- Code Information
summary: Return section notes for the given cpt/hcpcs {code}
operationId: getSectionNotes
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 99213
- name: data
in: query
description: indent indicates notes will include <indent> tags, only for CPT Code
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
item:
- 'INCLUDES:'
- 'Established patients: received prior professional services from physician or qualified health care professional or another physician or qualified health care professional in exact same specialty practice and subspecialty in previous three years (99211-99215)'
- 'New patients: have not received professional services from physician or qualified health care professional or any other physician or qualified health care professional in same practice in exact same specialty and subspecialty in previous three years (99202-99205)'
- Office visits
- Outpatient services (including services prior to formal admission to facility)
- 'EXCLUDES:'
- 'Services provided in:'
- Emergency department (99281-99285)
- Hospital observation (99217-99220 [99224, 99225, 99226])
- Hospital observation or inpatient with same day admission and discharge (99234-99236)
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Not Found - the data was not found
content:
application/json:
example:
error:
- The requested resource does not exist.
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
/codetype/{codetype}/{code}/physician-docs:
get:
tags:
- Code Information
summary: Return physician document for the given icd10cm {code}
operationId: getPhysicianDocs
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- icd10cm
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: S52
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/PhysicianDocs'
example:
physicianDoc:
- title: Fracture 7th characters
text: 'The 7th character in fractures is based on the Gustillo classification. The following information is important to assign the appropriate 7th character:
- Episode of care - Initial, subsequent, sequela
- Initial encounter - patient is receiving active treatment for the fracture
- Examples - surgical treatment, emergency department encounter, evaluation by new physician
- Subsequent encounter - patient has completed active treatment for the condition
- Examples - cast change/removal, medication adjustment, followup visits
- Sequela - complications or conditions that arise as a direct result of a condition
- Example - scar from a burn. The scar would be coded separately, but the burn would be assigned the "S" seventh character as the injury responsible for the scar.
- Open or closed fracture
- If open, Type I or Type II (Gustillo classification)
- If open, Type IIIA, IIIB, or IIIC
- Healing
- Routine healing
- Delayed healing
- Malunion
- Nonunion
'
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/PhysicianDocs'
example:
error:
- The code provided ('33213') in this web service request is not a valid 'icd10cm' code.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code {code} does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/PhysicianDocs'
example:
error:
- Code 'J00.99' does not exist
warning: []
info: []
'405':
description: Method Not Allowed - Request method not supported
content:
application/json:
example:
timestamp: '2022-07-07T15:28:34.152Z'
status: 405
error: Method Not Allowed
'503':
description: Service Unavailable
components:
schemas:
CciColumn1:
type: object
properties:
modifierAllowed:
type: boolean
xml:
name: modifier-allowed
reason:
type: string
code:
type: string
xml:
attribute: true
href:
type: string
xml:
attribute: true
Entry:
required:
- cpt
- definition
- hcpcs
- icd9
- synonyms
type: object
properties:
definition:
type: string
icd9:
type: string
cpt:
type: string
hcpcs:
type: string
synonyms:
type: string
term:
type: string
xml:
attribute: true
Link:
type: object
properties:
href:
type: string
xml:
attribute: true
value:
type: string
NewCookie:
type: object
properties:
name:
type: string
value:
type: string
version:
type: integer
format: int32
path:
type: string
domain:
type: string
comment:
type: string
maxAge:
type: integer
format: int32
expiry:
type: string
format: date-time
secure:
type: boolean
httpOnly:
type: boolean
sameSite:
type: string
enum:
- NONE
- LAX
- STRICT
IndexSearchResults:
required:
- indexSearchResult
type: object
properties:
indexSearchResult:
type: array
xml:
name: index-search-result
items:
$ref: '#/components/schemas/IndexSearchResult'
xml:
name: index-search-results
CodeHistory:
type: object
properties:
changeEffectiveDate:
type: string
xml:
name: ChangeEffectiveDate
status:
type: string
xml:
name: Status
changeSummary:
type: string
xml:
name: ChangeSummary
fullInfo:
type: string
xml:
name: FullInfo
char48Info:
type: string
xml:
name: Char48Info
char35Info:
type: string
xml:
name: Char35Info
codeHistoryReferences:
$ref: '#/components/schemas/CodeHistoryReferences'
PhysicianDocs:
type: object
properties:
physicianDoc:
type: array
xml:
name: physician-doc
items:
$ref: '#/components/schemas/PhysicianDoc'
xml:
name: physician-docs
Code2:
type: object
properties:
description:
type: string
reason:
type: string
modifier:
type: string
primarysecondary:
type: string
notes:
type: string
value:
type: string
xml:
attribute: true
MediaType:
type: object
properties:
type:
type: string
subtype:
type: string
parameters:
type: object
additionalProperties:
type: string
wildcardType:
type: boolean
wildcardSubtype:
type: boolean
Conflict:
type: object
properties:
code1:
$ref: '#/components/schemas/Code1'
code2:
$ref: '#/components/schemas/Code2'
name:
type: string
message:
type: string
Response:
type: object
properties:
entityTag:
$ref: '#/components/schemas/EntityTag'
mediaType:
$ref: '#/components/schemas/MediaType'
metadata:
type: object
properties:
empty:
type: boolean
additionalProperties:
type: array
items:
type: object
length:
type: integer
format: int32
location:
type: string
format: uri
language:
type: object
properties:
language:
type: string
displayName:
type: string
country:
type: string
variant:
type: string
script:
type: string
unicodeLocaleAttributes:
uniqueItems: true
type: array
items:
type: string
unicodeLocaleKeys:
uniqueItems: true
type: array
items:
type: string
displayLanguage:
type: string
displayScript:
type: string
displayCountry:
type: string
displayVariant:
type: string
extensionKeys:
uniqueItems: true
type: array
items:
type: string
iso3Language:
type: string
iso3Country:
type: string
date:
type: string
format: date-time
lastModified:
type: string
format: date-time
headers:
type: object
properties:
empty:
type: boolean
additionalProperties:
type: array
items:
type: object
closed:
type: boolean
status:
type: integer
format: int32
entity:
type: object
links:
uniqueItems: true
type: array
items:
$ref: '#/components/schemas/Link'
cookies:
type: object
additionalProperties:
$ref: '#/components/schemas/NewCookie'
allowedMethods:
uniqueItems: true
type: array
items:
type: string
statusInfo:
$ref: '#/components/schemas/StatusType'
stringHeaders:
type: object
properties:
empty:
type: boolean
additionalProperties:
type: array
items:
type: string
InstructionalNotes:
type: object
properties:
instructionalNote:
type: array
xml:
name: instructional-note
items:
$ref: '#/components/schemas/InstructionalNote'
xml:
name: instructional-notes
IndexSearchResult:
type: object
properties:
term:
type: string
level:
type: integer
format: int64
codes:
type: string
Items:
type: object
properties:
item:
type: array
items:
type: string
xml:
name: items
IngenixCodersDictionary:
required:
- entry
type: object
properties:
entry:
type: array
items:
$ref: '#/components/schemas/Entry'
xml:
name: optum360-coders-dictionary
Cci:
required:
- cciColumn1
- cciColumn2
type: object
properties:
cciColumn2:
type: array
xml:
name: cci-column2
items:
$ref: '#/components/schemas/CciColumn2'
cciColumn1:
type: array
xml:
name: cci-column1
items:
$ref: '#/components/schemas/CciColumn1'
xml:
name: cci
StatusType:
type: object
properties:
reasonPhrase:
type: string
family:
type: string
enum:
- INFORMATIONAL
- SUCCESSFUL
- REDIRECTION
- CLIENT_ERROR
- SERVER_ERROR
- OTHER
statusCode:
type: integer
format: int32
CciColumn2:
type: object
properties:
modifierAllowed:
type: boolean
xml:
name: modifier-allowed
reason:
type: string
code:
type: string
xml:
attribute: true
href:
type: string
xml:
attribute: true
Multicci:
required:
- conflict
type: object
properties:
conflict:
type: array
items:
$ref: '#/components/schemas/Conflict'
xml:
name: multicci
CodeProperties:
type: object
properties:
desc35:
type: string
xml:
name: desc-35
desc48:
type: string
xml:
name: desc-48
desc255:
type: string
xml:
name: desc-255
descFull:
type: string
xml:
name: desc-full
descLay:
type: string
xml:
name: desc-lay
codingTip:
type: string
xml:
name: coding-tip
documentationTip:
type: string
xml:
name: documentation-tip
reimbursementTip:
type: string
xml:
name: reimbursement-tip
xml:
name: code-properties
Code1:
type: object
properties:
description:
type: string
reason:
type: string
modifier:
type: string
primarysecondary:
type: string
notes:
type: string
value:
type: string
xml:
attribute: true
InstructionalNote:
required:
- note
type: object
properties:
header:
type: string
note:
type: array
items:
type: string
EntityTag:
type: object
properties:
value:
type: string
weak:
type: boolean
PhysicianDoc:
required:
- text
type: object
properties:
title:
type: string
text:
type: string
CompleteCodeHistory:
required:
- codeHistory
type: object
properties:
codeHistory:
type: array
xml:
name: code-history
items:
$ref: '#/components/schemas/CodeHistory'
xml:
name: complete-code-history
CodeHistoryReferences:
type: object
properties:
notInAmaBook:
type: string
xml:
name: NotInAmaBook
retroactive:
type: string
xml:
name: Retroactive
securitySchemes:
bearerAuth:
type: http
scheme: bearer
ws_auth:
type: oauth2
flows:
authorizationCode:
authorizationUrl: https://idx.linkhealth.com/auth
tokenUrl: https://idx.linkhealth.com/auth/token
scopes:
scope-1: required scope for API access
x-readme:
explorer-enabled: true
proxy-enabled: true