openapi: 3.2.0 info: title: CMS Common Facility DRG Information APIs API description: MicroService that contains CMS related information contact: name: Ken Kracker email: ken.kracker@optum.com version: v1.0 servers: - url: /v1/cmscommonms tags: - name: DRG Information APIs paths: /api/cms/facility/{codetype}/{code}/drgs: get: tags: - DRG Information APIs summary: Fetches the DRG codes for given icd code operationId: drgCodesForIcdCode parameters: - name: codetype in: path required: true schema: type: string enum: - i9v1 - i9v3 - i10_cm - i10_pcs example: i10_cm - name: code in: path required: true schema: type: string example: I60.00 - name: limit in: query required: false schema: type: integer format: int32 default: 50 - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: sort in: query description: Any of these (drgCode,-drgCode) are allowed values. required: false schema: type: array items: type: string default: - drgCode - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetch MCE edits data content: application/json: example: content: - drgCode: '020' fullDescription: Intracranial Vascular Procedures with Principal Diagnosis of Hemorrhage with MCC mdc: '1' mdcDescription: Diseases And Disorders Of The Nervous System medSurg: S gmLos: '10.2' amLos: '14.1' relativeWeight: '8.4524' nationalPayment: '54042.79' - drgCode: '021' fullDescription: Intracranial Vascular Procedures with Principal Diagnosis of Hemorrhage with CC mdc: '1' mdcDescription: Diseases And Disorders Of The Nervous System medSurg: S gmLos: '6.3' amLos: '9.0' relativeWeight: '6.1414' nationalPayment: '39266.76' - drgCode: '022' fullDescription: Intracranial Vascular Procedures with Principal Diagnosis of Hemorrhage without CC/MCC mdc: '1' mdcDescription: Diseases And Disorders Of The Nervous System medSurg: S gmLos: '2.5' amLos: '3.9' relativeWeight: '3.4767' nationalPayment: '22229.25' totalCount: 3 '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2024-04-12T13:52:54.478+00:00' status: 404 error: Not Found trace: 'org.springframework.web.servlet.resource.NoResourceFoundException: No static resource api/cms/cms/facility/cpt/99213/drgs.' security: - bearerAuth: [] /api/cms/facility/mdc/{codetype}/{mdccode}/drg: get: tags: - DRG Information APIs summary: Fetches DRG codes for the given MDC code for icd10 or icd9 codetype operationId: fetchDRGCodeListForMDC parameters: - name: codetype in: path required: true schema: type: string enum: - icd9 - icd10 - name: mdccode in: path required: true schema: type: string example: 1 - name: limit in: query required: false schema: type: integer format: int32 default: 50 example: 150 - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetch MDC Data for icd9 and icd10 content: application/json: example: content: - drgCode: '927' fullDescription: Extensive Burns or Full Thickness Burns with Mechanical Ventilation 96+ Hours with Skin Graft relativeWeight: '15.5499' - drgCode: '928' fullDescription: Full Thickness Burn with Skin Graft or Inhalation Injury with CC/MCC relativeWeight: '5.3820' - drgCode: '929' fullDescription: Full Thickness Burn with Skin Graft or Inhalation Injury without CC/MCC relativeWeight: '2.3344' - drgCode: '933' fullDescription: Extensive Burns or Full Thickness Burns with Mechanical Ventilation 96+ Hours without Skin Graft relativeWeight: '2.7557' - drgCode: '934' fullDescription: Full Thickness Burn without Skin Graft or Inhalation Injury relativeWeight: '1.5748' - drgCode: '935' fullDescription: Nonextensive Burns relativeWeight: '1.4717' totalCount: 6 '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2024-05-16T07:02:57.183+00:00' status: 404 error: Not Found trace: 'org.springframework.web.servlet.resource.NoResourceFoundException: No static resource api/cms/facility/mdc/cpt/1/drg.' '500': description: Internal server error content: application/json: example: timestamp: '2024-05-16T07:15:00.252+00:00' status: 500 error: Internal Server Error path: cmscommonms/api/cms/facility/mdc/icd9/1/drg message: 'java.lang.IllegalArgumentException: Page index must not be less than zero' security: - bearerAuth: [] /api/cms/facility/mdc/{codetype}/all: get: tags: - DRG Information APIs summary: Fetches MDC data for icd10 and icd9 operationId: fetchMCEEdits_1 parameters: - name: codetype in: path required: true schema: type: string enum: - icd9 - icd10 - name: limit in: query required: false schema: type: integer format: int32 default: 50 example: 150 - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: filter in: query required: false schema: type: string - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetch MDC Data for icd9 and icd10 content: application/json: example: content: - code: '11' fullDescription: Diseases And Disorders Of The Kidney And Urinary Tract version: '41.1' releaseDate: '2024-04-01 00:00:00' totalCount: 1 '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2024-05-09T07:02:57.183+00:00' status: 404 error: Not Found trace: 'org.springframework.web.servlet.resource.NoResourceFoundException: No static resource api/cms/facility/mdc/cpt/all.' '500': description: Internal server error content: application/json: example: timestamp: '2024-05-09T07:15:00.252+00:00' status: 500 error: Internal Server Error path: cmscommonms/api/cms/facility/mdc/icd10/all message: 'java.lang.IllegalArgumentException: Page index must not be less than zero' security: - bearerAuth: [] /api/cms/facility/drg/{drg-code}/icd9/cross-codes: get: tags: - DRG Information APIs summary: Fetches the ICD9 specific codes for corresponding DRG cross code operationId: getI9CodesForDrgCode parameters: - name: drg-code in: path description: Drg Cross Codes required: true schema: type: string example: '001' - name: limit in: query required: false schema: type: integer format: int32 default: 50 example: 150 - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: filter in: query required: false schema: type: string - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetches the ICD9 specific codes for corresponding DRG cross code content: application/json: example: content: - code: '174.0' codeDescription: Malignant neoplasm of nipple and areola of female breast - code: '175.0' codeDescription: Malignant neoplasm of nipple and areola of male breast totalCount: 2 '400': description: Bad request content: application/json: example: error: - 'filter : length must be between 2 and 180' warning: null info: null '500': description: Internal server error content: application/json: example: timestamp: '2023-07-27T08:10:07.573+00:00' status: 500 error: Internal Server Error path: /cmscommonms/api/cms/facility/drg/582/icd9/cross-codes security: - bearerAuth: [] /api/cms/facility/drg/{drg-code}/icd10/cross-codes: get: tags: - DRG Information APIs summary: Fetches the I10 specific codes for corresponding DRG cross code operationId: getI10CodesForDrgCode parameters: - name: drg-code in: path description: Drg Cross Codes required: true schema: type: string example: '001' - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetches the I10 specific codes for corresponding DRG cross code content: application/json: example: - sortOrder: '1' term: Heart Transplant Operating Room Procedures codes: - code: 02YA0Z0 codeTypeId: '32768' term: Transplantation of Heart, Allogeneic, Open Approach exceptionFlag: N - code: 02YA0Z1 codeTypeId: '32768' term: Transplantation of Heart, Syngeneic, Open Approach exceptionFlag: N - code: 02YA0Z2 codeTypeId: '32768' term: Transplantation of Heart, Zooplastic, Open Approach exceptionFlag: N - sortOrder: '2' term: OR indent: '2' codes: - code: 02RK0JZ codeTypeId: '32768' term: Replacement of Right Ventricle with Synthetic Substitute, Open Approach exceptionFlag: N '400': description: Bad request content: application/json: example: error: - 'drgCode : length must be between 3 and 3' warning: null info: null '500': description: Internal server error content: application/json: example: timestamp: '2023-07-27T08:10:07.573+00:00' status: 500 error: Internal Server Error path: /cmscommonms/api/cms/facility/drg/001/icd10/cross-codes security: - bearerAuth: [] /api/cms/facility/drg/{codetype}/all: get: tags: - DRG Information APIs summary: Fetches all DRG codes for given code group (icd9/icd10) operationId: drgCodesAll parameters: - name: codetype in: path required: true schema: type: string enum: - icd9 - icd10 - name: limit in: query required: false schema: type: integer format: int32 default: 50 - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: filter in: query required: false schema: type: string - name: sort in: query description: Any of these (drgCode,-drgCode) are allowed values. required: false schema: type: array items: type: string default: - drgCode - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetch MCE Edits Data content: application/json: example: content: - drgCode: '010' fullDescription: Pancreas Transplant mdc: PRE mdcDescription: Pre MDC medSurg: S gmLos: '7.8000' amLos: '9.6000' relativeWeight: '4.0849' nationalPayment: '22055.4800' - drgCode: '011' fullDescription: Tracheostomy for Face, Mouth, and Neck Diagnoses with MCC mdc: PRE mdcDescription: Pre MDC medSurg: S gmLos: '11.3000' amLos: '14.1000' relativeWeight: '4.7380' nationalPayment: '25581.7400' - drgCode: '012' fullDescription: Tracheostomy for Face, Mouth, and Neck Diagnoses with CC mdc: PRE mdcDescription: Pre MDC medSurg: S gmLos: '8.4000' amLos: '10.0000' relativeWeight: '3.3293' nationalPayment: '17975.7900' totalCount: 3 '400': description: Bad request content: application/json: schema: $ref: '#/components/schemas/Notification' example: error: - 'filter : length must be between 2 and 180' warning: null info: null '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2024-04-12T13:52:54.478+00:00' status: 404 error: Not Found trace: 'org.springframework.web.servlet.resource.NoResourceFoundException: No static resource api/cms/facility/drg/icd9/all.' security: - bearerAuth: [] components: schemas: Notification: type: object properties: error: type: array items: type: string warning: type: array items: type: string info: type: array items: type: string securitySchemes: bearerAuth: type: http scheme: bearer bearerFormat: JWT x-readme: explorer-enabled: true proxy-enabled: true