openapi: 3.2.0 info: title: Optum Common Facility OPSI Codes APIs API description: MicroService that contains Optum module-related information contact: name: Ken Kracker email: ken.kracker@optum.com version: v1.0 servers: - url: /v1/optumcommonms tags: - name: OPSI Codes APIs paths: /api/optum/facility/opsi-codes: get: tags: - OPSI Codes APIs summary: Fetches the list of OPSI codes operationId: fetchOpsiCodesList parameters: - name: sort in: query description: Any of these values (code , -code) are allowed.The default is code required: false schema: type: array items: type: string default: - code - 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 list of OPSI codes content: application/json: example: content: - code: A opsiCodeId: '1' opsiCodeLink: value: A href: /api/optum/facility/opsi-codes/codes-associated-with-opsi/A/1 description: DMEPOS Fee Schedule paymentStatus: DMEPOS Fee Schedule paymentCalculation: DMEPOS fee schedule for the specific area. tips: Non-implantable prosthetics, and orthotics can be billed to the fiscal intermediary by hospitals and are paid under the DMEPOS fee schedule. - code: A opsiCodeId: '2' opsiCodeLink: value: A href: /api/optum/facility/opsi-codes/codes-associated-with-opsi/A/2 description: Physical, Occupational and Speech Therapy paymentStatus: Physician Fee Schedule paymentCalculation: MAC-specific fee schedule. '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2023-07-14T06:37:03.741+00:00' status: 404 error: Not Found message: Not Found path: /optumcommonms/api/optum/facility/opsi-code '500': description: Internal server error content: application/json: example: timestamp: '2023-07-28T06:36:22.518+00:00' path: /optumcommonms/api/optum/facility/opsi-codes status: 500 error: Internal Server Error requestId: e36d239e-324 security: - bearerAuth: [] /api/optum/facility/opsi-codes/quarters/{code}: get: tags: - OPSI Codes APIs summary: Fetches the list of OPSI hac quarters for CPT HCPS code operationId: fetchOpsiCodeQuarterList parameters: - name: code in: path required: true schema: type: string example: 99213 - 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 list of OPSI hac quarters for CPT HCPCS code content: application/json: example: - code: B year: 2025-1 - code: B year: 2024-4 - code: B year: 2024-3 - code: B year: 2024-2 '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2023-07-14T06:37:03.741+00:00' status: 404 error: Not Found message: Not Found path: optumcommonms/api/optum/facility/opsi-codes/quarter/99213 '500': description: Internal server error content: application/json: example: timestamp: '2025-01-10T06:36:22.518+00:00' path: optumcommonms/api/optum/facility/opsi-codes/quarters/99213 status: 500 error: Internal Server Error requestId: e36d239e-324 security: - bearerAuth: [] /api/optum/facility/opsi-codes/codes-associated-with-opsi/{opsi-code}/{opsi-code-id}: get: tags: - OPSI Codes APIs summary: Fetches the list of cpt or hcpcs code associated with particular OPSI Code operationId: fetchOpsiCodesList_1 parameters: - name: opsi-code-id in: path required: true schema: type: string example: 1 - name: opsi-code in: path required: true schema: type: string example: A - name: sort in: query description: Any of these values (code , -code) are allowed.The default is code required: false schema: type: array items: type: string default: - code - 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: Fetches the list of cpt or hcpcs code associated with particular OPSI code content: application/json: example: content: - code: 0001F description: 'Heart failure assessed (includes assessment of all the following components) (CAD): Blood pressure measured (2000F) Level of activity assessed (1003F) Clinical symptoms of volume overload (excess) assessed (1004F) Weight, recorded (2001F) Clinical signs of volume overload (excess) assessed (2002F)' title: Non-Covered Items and Services based on Statutory exclusions, Not covered by any Medicare outpatient benefit category, Not reasonable and necessary - code: 0005F description: 'Osteoarthritis assessed (OA) Includes assessment of all the following components: Osteoarthritis symptoms and functional status assessed (1006F) Use of anti-inflammatory or over-the-counter (OTC) analgesic medications assessed (1007F) Initial examination of the involved joint(s) (includes visual inspection, palpation, range of motion) (2004F)' title: Non-Covered Items and Services based on Statutory exclusions, Not covered by any Medicare outpatient benefit category, Not reasonable and necessary '404': description: Not found content: application/json: schema: $ref: '#/components/schemas/Notification' example: timestamp: '2023-07-14T06:37:03.741+00:00' status: 404 error: Not Found message: Not Found path: /optumcommonms/api/optum/facility/opsi-code/codes-associated-with-opsi/A/1/ '500': description: Interal server error content: application/json: example: timestamp: '2023-07-28T06:36:22.518+00:00' path: /optumcommonms/api/optum/facility/opsi-code/codes-associated-with-opsi/A/1 status: 500 error: Internal Server Error requestId: e36d239e-324 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