openapi: 3.0.1
info:
title: Optum Real-Time eContent Web services
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 CodeLogicâ„¢ 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: []
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}/cdi:
get:
tags:
- CDI Information
summary: Return the list of CDI documents for the given code
operationId: getCDICodeLinks
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
required: true
schema:
type: string
example: 99213
- name: data
in: query
description: associatedcodes indicates will include a comma separated list of Codes associated
to CDI.
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Cdi'
example:
cdiDoc:
- url: /documents/550392
pdftitle: 'Lower Extremity Endovascular Revascularization:'
sourcetitle: Facility Documentation Improvement Instructions
- url: /documents/59046
pdftitle: Percutaneous Coronary Interventions (PTCA and Atherectomy, with or without
Stent Placement)
sourcetitle: Facility Documentation Improvement Instructions
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/Cdi'
example:
error:
- The code provided ('0019T') in this web service request is not a valid '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: CDI Document not found
content:
application/json:
schema:
$ref: '#/components/schemas/Cdi'
example:
error: []
warning: []
info:
- CDI Document not found for the code 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
/documents/{docId}:
get:
tags:
- CDI and Coding Support PDF Information
summary: Return the CDI and Coding Support PDF Document
operationId: getCDIPDF
parameters:
- name: docId
in: path
description: The Document Id (max 6 chars)
required: true
schema:
type: integer
format: int32
example: 470866
responses:
'200':
description: Successful Response
content:
application/pdf:
schema:
type: string
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: CDI or Coding Support PDF Document not found
content:
application/pdf:
schema:
type: string
example: CDI or Coding Support PDF Document 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
/icd10physdoc/{docId}:
get:
tags:
- CDI Information
summary: Return the ICD10 Physician CDI PDF Document
operationId: getCDIPDF_1
parameters:
- name: docId
in: path
description: The Document Id (max 3 chars)
required: true
schema:
type: integer
format: int32
example: 638
responses:
'200':
description: Successful Response
content:
application/pdf:
schema:
type: string
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: CDI Document not found
content:
application/pdf:
schema:
type: string
example: CDI Document 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
/claims5x:
get:
tags:
- Claim Review
summary: Get Claims Information
operationId: getClaims
responses:
'200':
description: Successful Response
content:
application/xml:
schema:
type: string
example: "\n\n \n \
\ \n 2009-07-16\n\
\ E10.9\n E10.19\n\
\ 21\n 51\n 13100\n\
\ \n \n 2009-07-16\n\
\ E10.9\n 250.01\n\
\ 21\n 51\n 13100\n\
\ 11\n 1\n \n\
\ 2009-07-16\n 2009-07-16\n\
\ M\n 10102\n 208600000X\n\
\ \n"
'401':
description: Not Authorised
content:
application/json:
schema:
$ref: '#/components/schemas/ClaimResponses'
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
post:
tags:
- Claim Review
summary: Get Claims Responses
operationId: process
requestBody:
description: Term Search Request.
content:
application/xml:
schema:
$ref: '#/components/schemas/ClaimResponses'
examples:
Claim Request:
description: Claim Request
value: "\n\n \n \
\ \n 2009-07-16\n\
\ E10.9\n E10.19\n\
\ 21\n 51\n 13100\n\
\ \n \n 2009-07-16\n\
\ E10.9\n 250.01\n\
\ 21\n 51\n 13100\n\
\ 11\n 1\n \n\
\ 2009-07-16\n 2009-07-16\n\
\ M\n 10102\n 208600000X\n\
\ \n"
required: true
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ClaimResponses'
example:
claimResponse:
- edit:
- description: '[Pattern 8400] The diagnosis code(s) E1019 and E109 are invalid.'
editConflict: Invalid Diagnosis Code
editType: Review
mnemonic: ICD
line: 1
- description: '[Pattern 13248] The modifier code(s) 21 are invalid.'
editConflict: Invalid Modifier
editType: Review
mnemonic: IMO
line: 1
- description: '[Pattern 8400] The diagnosis code(s) 25001 and E109 are invalid.'
editConflict: Invalid Diagnosis Code
editType: Review
mnemonic: ICD
line: 2
- description: '[Pattern 13248] The modifier code(s) 21 are invalid.'
editConflict: Invalid Modifier
editType: Review
mnemonic: IMO
line: 2
claimId: '1'
'400':
description: Bad Request
content:
application/json:
schema:
$ref: '#/components/schemas/ClaimResponses'
example: "\n\n\
\ Unexpected close tag </servce-date>; expected </service-date>.\n\
\ at [row,col {unknown-source}]: [48,41]\n"
'401':
description: Not Authorised
content:
application/json:
schema:
$ref: '#/components/schemas/ClaimResponses'
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
/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/cpt/{code}/color-codes:
get:
tags:
- Color Codes
summary: Show Color Codes for the given CPT code
operationId: getColorCodes
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: 13100
- name: data
in: query
description: desc
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
modifier51Exempt: []
ascPaymentIndicator: ' A2'
ascPaymentIndicatorDescription: ' Surgical procedure on ASC list in CY 2007; payment based
on OPPS relative payment weight.'
medicalUnlikelyEdits: '1'
opsiCode: ' T'
mulitplePxReductionGuidelinesApply: ''
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
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: Code does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
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}/{crosscodetype}:
get:
tags:
- OPPS CrossCode Code
summary: Show OPPS CrossCode for the Code
operationId: getOPPSCrossCode
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 for which you want OPPS crosscode
required: true
schema:
type: string
- name: crosscodetype
in: path
description: The cross-code for the given codetype
required: true
schema:
type: string
example: icd9v1
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/OPPSCrossCode'
example: "{\n \"oppscrosscode\": [\n {\n \"Code\": 27096,\n \"Description\"\
: \"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance\
\ (fluoroscopy or CT) including arthrography when performed,\"\n \"Reference\
\ Cross Code\": G0259,G0260,\n \"Effective Date\": \"\x01/01/2000\"\n \
\ }\n ]\n}"
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/OPPSCrossCode'
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: OPPS crosscode was not found
content:
application/json:
schema:
$ref: '#/components/schemas/OPPSCrossCode'
example:
error: []
warning: []
info:
- OPPS crosscode 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/hcpcs/{code}/color-codes:
get:
tags:
- Color Codes
summary: Show Color Codes for the given HCPCS code
operationId: getColorCodes_1
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: A0080
- name: data
in: query
description: desc
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
modifier51Exempt: []
ascPaymentIndicator: ' IC'
ascPaymentIndicatorDescription: ' Surgical procedure on ASC list in CY 2007; payment based
on OPPS relative payment weight.'
medicalUnlikelyEdits: '0'
opsiCode: ' E1'
notCoveredOrValidForMedicare: 01/01/2007
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
error:
- The code provided ('250.02') in this web service request is not a valid '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: Code does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
error:
- Code A0000 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/icd10cm/{code}/color-codes:
get:
tags:
- Color Codes
summary: Show Color Codes for the given ICD10CM code
operationId: getColorCodes_2
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: S82.91XB
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10CmColorCodes'
example:
unspecifiedDiagnosisCode: OP
comorbidityOrComplication: IP
hospitalAcquiredCondition:
- 'HAC 05: Falls and trauma (secondary diagnosis)'
conditionalHospitalAcquiredCondition: []
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10CmColorCodes'
example:
error:
- The code provided ('13100') 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 does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10CmColorCodes'
example:
error:
- ICD-10-CM code 'F90.7' not found
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/icd10pcs/{code}/color-codes:
get:
tags:
- Color Codes
summary: Show Color Codes for the given ICD10PCS code
operationId: getColorCodes_3
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: 04LE0CV
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10pcsColorCodes'
example: '{
"mappingToIcd9Code": "OP",
"procedureInconsistentLOS": "IP",
}
'
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10pcsColorCodes'
example:
error:
- The code provided ('13100') in this web service request is not a valid 'icd10pcs' 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/Icd10pcsColorCodes'
example:
error:
- ICD-10-PCS code 'F90.7' not found
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/icd9v1/{code}/color-codes:
get:
tags:
- Color Codes
summary: Show Color Codes for the given ICD9V1 code
operationId: getColorCodes_4
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: 253.1
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
modifier51Exempt: []
unspecifiedDiagnosisCode: OP
otherSpecifiedDiagnosisCode: OP
comorbidityOrComplication: IP
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
error:
- The code provided ('13100') 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 does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/ColorCodes'
example:
error:
- CPT code '000.1' not found
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/icd10cm/{code}/code-specific-guidelines:
get:
tags:
- Code Specific Guidelines
summary: Show Color Codes for the given ICD10CM code
operationId: getCodeSpecificGuidelines
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: A00.1
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10CmColorCodes'
example: "{\n \"mappingToIcd9Code\": \"OP\",\n \"procedureInconsistentLOS\": \"\
IP\",\n }\n"
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10CmColorCodes'
example:
error:
- The code provided ('13100') in this web service request is not a valid 'icd10pcs' 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/Icd10CmColorCodes'
example:
error:
- ICD-10-PCS code 'F90.7' not found
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/icd10pcs/{code}/code-specific-guidelines:
get:
tags:
- Code Specific Guidelines
summary: Show Code Specific Guidelines for the given ICD10PCS code
operationId: getCodeSpecificGuidelines_1
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: D0001ZZ
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10pcsCodeSpecificGuidelines'
example: '{
"mappingToIcd9Code": "OP",
"procedureInconsistentLOS": "IP",
}
'
'400':
description: Wrong CodeType
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10pcsCodeSpecificGuidelines'
example:
error:
- The code provided ('13100') in this web service request is not a valid 'icd10pcs' 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/Icd10pcsCodeSpecificGuidelines'
example:
error:
- ICD-10-PCS code 'F90.7' not found
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/{codetype}:
get:
tags:
- Reference Code
summary: Return the first 100 codes for the given 'codetype' parameter
operationId: getCodes
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: start
in: query
description: The starting index for code list
schema:
type: integer
format: int32
default: 0
responses:
'200':
description: Successful Response - codetype - cpt
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/codetype/cpt/0001A
value: 0001A
- href: /ws/codetype/cpt/0001F
value: 0001F
'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
/codetype/{codetype}/{code}/range:
get:
tags:
- Reference Code
summary: Return code range
operationId: findRange
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: Code to find the range
required: true
schema:
pattern: '[^/]+'
type: string
example: 99213
- name: rangeId
in: query
description: 'Internal use: used for finding next/previous range'
schema:
type: integer
format: int32
example: 1
- name: direction
in: query
description: 'Internal use: one of- next: next range
- previous: previous range
'
schema:
type: string
example: next
- name: data
in: query
description: 'Comma seperated list of any of the following- desc-full : full description
- headers : Headers from the Code Book separated by ^
- tabulardata :
Tabular data from the Code Book separated by ^. It shown in the pattern of ^<<Tab Name>>^<<Indent
Level 1>>^<<Indent Level 2>>^<<Tabular Text>>^<<Links>>^. For Example,
One of the Tabular data for ICD-9-V1 code ''474.1'' is rendered as ''^Excludes A^4.3^null^adenoiditis^
|[474.01]^''. Here, Tab Name=Excludes A; Indent Level 1=4.3; Indent Level 2=null; Tabular Text=adenoiditis;
Links=|[474.01].
- billableonly: to request return of billable codes only (no digit
color code edit exists for that code)
'
schema:
type: string
default: desc-full
example: desc-full
- name: yyyy-mm-dd
in: header
description: Historical Application Content(HAC) is not applicable here. This RangeResource webservice
accepts Current 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/CodeRange'
example:
rangeId: 1
rangeItem:
- code: '99202'
description: Office or other outpatient visit for the evaluation and management of a
new patient, which requires a medically appropriate history and/or examination and
straightforward medical decision making. When using time for code selection, 15-29
minutes of total time is spent on the date of the encounter.
href: /ws/codetype/cpt/99202
- code: '99203'
description: Office or other outpatient visit for the evaluation and management of a
new patient, which requires a medically appropriate history and/or examination and
low level of medical decision making. When using time for code selection, 30-44 minutes
of total time is spent on the date of the encounter.
href: /ws/codetype/cpt/99203
link:
- href: /ws/codetype/cpt/99202/range?rangeId=1&direction=next&data=desc-full
value: Next
'400':
description: Not a valid 'codetype' code
content:
application/json:
schema:
$ref: '#/components/schemas/CodeRange'
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/{codetype}/termsearch/{terms}:
get:
tags:
- Reference Code
summary: Return codes that match given terms sorted by ranking
operationId: termSearch
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
- all
- name: terms
in: path
description: Terms to search for
required: true
schema:
pattern: '[^/]+'
type: string
example: conjunctivitis
- name: data
in: query
description: 'Comma seperated list of- rank : To return a numeric rank. More relevant results
have a higher rank
- desc: To show the 255 character description
- desc-full: To
show the full character description
- billableonly: to request return of billable codes
only (no digit color code edit exists for that code)
'
schema:
type: string
example: desc,rank,desc-full
- name: start
in: query
description: The zero relative row to start at
schema:
type: integer
format: int32
default: 0
- name: maxresults
in: query
description: The number of rows be returned
schema:
type: integer
format: int32
default: 100
- name: suggest
in: query
description: 'Suggest alternate spellings? : true/false'
schema:
type: boolean
default: false
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/TermSearchResults'
example:
termSearchResult:
- code: H10.89
rank: 6081463
href: /ws/codetype/icd10cm/H10.89
codeType: 16384
- code: H10.9
rank: 6076765
href: /ws/codetype/icd10cm/H10.9
codeType: 16384
link: []
'300':
description: Multiple Choices
content:
application/json:
schema:
$ref: '#/components/schemas/TermSearchResults'
example:
target:
- choice:
- BROKEN
- BRAKING
- PROKINOGENASE
- PROGEN
- BARKAN'S
- PREGNACY
- PRKNS
- BARKING
input: BRIKEN
- choice:
- CHEST
- CHEST4
- CHESTER
- CHESTERMANI
- SCHISTOCELIA
- SCHISTOGLOSSIA
- SCHISTOSOMA
- SCHISTOSOME
- SCHISTOSOMAL
- SCHISTOSOMES
- SCHISTOSOMIASIS
- SCHIZOTHYMIA
- SCHIZOTYPAL
- SCHIZOID
- SCHIZODONTIA
input: CHIST
'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}/termsearchgroups/{terms}:
get:
tags:
- Reference Code
summary: Return the terms by ranking for all the available code types
operationId: termSearchGroups
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
- all
- name: terms
in: path
description: Terms to search for
required: true
schema:
pattern: '[^/]+'
type: string
example: conjunctivitis
- name: data
in: query
description: 'Comma seperated list of- rank : Return a numeric rank. More relevant results
have a higher rank
- desc: Return 255 character description
- desc-full: Return
Full description
'
schema:
type: string
example: rank,desc,desc-full
- name: maxresults
in: query
description: The number of results to be returned
schema:
type: string
default: '100'
- name: yyyy-mm-dd
in: header
description: Historical Application Content(HAC) is not applicable here. This Term Search Group
webservice accepts Current 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/TermSearchGroups'
example:
termSearchGroup:
- node:
- node: []
code: V74.4
rank: 5050897
hrefBeg: /ws/codetype/icd9v1/V74.4
code: V74
rank: 5050897
hrefBeg: /ws/codetype/icd9v1/V74
- node:
- node: []
code: '130.1'
rank: 5028176
hrefBeg: /ws/codetype/icd9v1/130.1
code: '130'
rank: 5028176
hrefBeg: /ws/codetype/icd9v1/130
'300':
description: Multiple Choices
content:
application/json:
schema:
$ref: '#/components/schemas/TermSearchGroups'
example:
target:
- choice:
- BROKEN
- BRAKING
- PROKINOGENASE
- PROGEN
- BARKAN'S
- PREGNACY
input: BRIKEN
- choice:
- CHEST
- CHEST4
- CHESTER
- CHESTERMANI
- SCHISTOCELIA
- SCHISTOGLOSSIA
- SCHISTOSOMA
- SCHISTOSOME
- SCHISTOSOMAL
- SCHISTOSOMES
- SCHISTOSOMIASIS
- SCHIZOTHYMIA
- SCHIZOTYPAL
- SCHIZOID
- SCHIZODONTIA
input: CHIST
'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}/coding-support:
get:
tags:
- Coding Support
summary: Show E&M Coding Assitant or Auditors Desk Reference documents
operationId: getDocuments
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: 13100
- name: codetype
in: path
description: The code value
required: true
schema:
type: string
enum:
- cpt
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/CodingSupportResources'
example: "{\n\n \"code\": \"99213\",\n\n \"referenced_document_type\"\
: \"Evaluation and Management Coding Assistant\",\n\n \"title\": \"Chapter\
\ 6: Office or Other Outpatient Services\",\n\n \"referenced_content_example\"\
: \"Medically appropriate 10 min. 99213 Low Medically appropriate Medically appropriate\
\ 20 min. 99214 Moderate Optum360, LLC CPT © 2023 American Medical Association. All\
\ Rights Reserved. 75 99213 DOCUMENTATION Medical Association. All Rights Reserved. Sample\
\ Documentation-99213 S: A 59-year-old male to Low MDM and code 99213. • Final E/M\
\ Level of Service: CPT code 99213 is assigned. Level III\",\n\n \"document\"\
: \"documents/506800\",\n\n}"
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/CodingSupportResources'
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: No E&M or auditor desk reference doucuments were found
content:
application/json:
schema:
$ref: '#/components/schemas/CodingSupportResources'
example:
error: []
warning: []
info:
- No E&M or auditor desk reference doucuments were 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
/contractors:
get:
tags:
- LCD
summary: List of medicare contractors who have policies
operationId: getContractors
parameters:
- name: contractor-type
in: query
description: 'Comma seperated list of - ALL : All of the following types of contractors
- CA :
Carriers
- DA : DME MAC
- DP : DME PSC
- FI : Fiscal Intermediary
- MA :
MAC Part A
- MB : MAC Part B
- NA : National Part A
- NB : National Part
B
- ND : National DME
'
schema:
type: string
default: CA,FI,MA,MB
- name: contractor-part
in: query
description: 'Comma seperated list of - ALL : Contractors for all of the parts below
- A
: Contractor for Part A policies
- B : Contractor for Part B policies
- DME : Contractor
for DME policies
'
schema:
type: string
default: A,B
- name: region-code
in: query
description: The region code for policies
schema:
type: string
default: ALL
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorList'
example:
contractor:
- regionCode: AK
regionName: Alaska
contractorName: BlueCross BlueShield of Tennessee (Riverbend Government Benefits Administrator)
contractorPart: A
contractorType: FI
contractorNumber: 00390
- regionCode: AK
regionName: Alaska
contractorName: Noridian Administrative Services
contractorPart: A
contractorType: FI
contractorNumber: '00322'
'400':
description: Not a valid 'codetype' code
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorList'
example:
error:
- Invalid value 'X' for parameter 'contractor-part'. Valid values are a comma seperated
list of ALL,A,B,DME,HM,MP,NR,PI,RI
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
/contractors/{contractorNum}/policies:
get:
tags:
- LCD
summary: Policies of a Medicare Contractor
operationId: getPolicies
parameters:
- name: contractorNum
in: path
description: The Contractor number (max 5 chars)
required: true
schema:
type: string
example: '04111'
- name: cms-id
in: query
description: The CMS Policy ID (Max 10 characters)
schema:
type: string
- name: contractor-part
in: query
description: 'Comma seperated list of - ALL : Contractors for all of the parts below
- A
: Contractor for Part A policies
- B : Contractor for Part B policies
- DME : Contractor
for DME policies
'
schema:
type: string
default: ALL
example: ALL
- name: contractor-type
in: query
description: 'Comma seperated list of - ALL : All of the following types of contractors
- CA :
Carriers
- DA : DME MAC
- DP : DME PSC
- FI : Fiscal Intermediary
- MA :
MAC Part A
- MB : MAC Part B
- NA : National Part A
- NB : National Part
B
- ND : National DME
'
schema:
type: string
default: ALL
example: ALL
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorPolicies'
example:
policy:
- title: 'Billing and Coding: Acute Care: Inpatient, Observation and Treatment Room Services'
effectiveDate: '2015-10-01T00:00:00.000Z'
url: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52985&ver=44&bc=0
cmsId: A52985
contractorNum: '04111'
contractorPart: A
contractorType: MA
- title: 'Billing and Coding: Information Regarding Uses, Including Off-Label Uses, of
Anti-Vascular Endothelial Growth Factor (anti-VEGF), for The Treatment of Ophthalmological
Diseases'
effectiveDate: '2016-07-11T00:00:00.000Z'
url: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53121&ver=35&bc=0
cmsId: A53121
contractorNum: '04111'
contractorPart: A
contractorType: MA
'400':
description: ContractorNum is larger than 5 characters
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorPolicies'
example:
error:
- ContractorNum is larger than 5 characters
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
/contractors/{contractorNum}/policy/{cmspolicyid}:
get:
tags:
- LCD
summary: Medicare Policiy Details
operationId: getPolicyDetails
parameters:
- name: contractorNum
in: path
description: The Contractor number (max 5 chars)
required: true
schema:
type: string
example: '04111'
- name: cmspolicyid
in: path
description: The CMS Policy ID (Max 10 characters)
required: true
schema:
type: string
example: A52985
- name: categories
in: query
description: 'Comma seperated list of - all : All Categories below
- tob : Type
of Bill Codes for lcd policies
- rev : Revenue Codes for lcd policies
- proc :
Procedure codes for ncd/lcd policies
- diag : All Diagnostic codes for ncd/lcd policies
- supp
: Supported Diagnostic codes for lcd policies
- cov : Covered Diagnostic Codes for ncd
policies
- deny : Denied Diagnostic Codes for ncd policies
- nots : Not Supported
Diagnostic codes for ncd/lcd policies
'
schema:
type: string
default: all
example: all
- name: icdtypes
in: query
description: 'Comma seperated list of - all : all icd types below
- icd9 : exclude
icd10cm and icd10pcs
- icd10 : exclude icd9v1 and icd9v3
'
schema:
type: string
default: all
example: all
- name: maxproc
in: query
description: The maximum number of procedure codes to be returned
schema:
type: integer
format: int32
default: 200
- name: maxcov
in: query
description: The maximum number of diagnostic codes to be returned under 'covered' for ncd policies
schema:
type: integer
format: int32
default: 200
- name: maxnots
in: query
description: The maximum number of diagnostic codes to be returned under 'not-supporting-medical-necessity'
for ncd/lcd policies
schema:
type: integer
format: int32
default: 200
- name: maxdeny
in: query
description: The maximum number of diagnostic codes to be returned under 'denied'
schema:
type: integer
format: int32
default: 200
- name: maxtob
in: query
description: The maximum number of codes to be returned under 'type-of-bill-codes' for lcd policies
schema:
type: integer
format: int32
default: 200
- name: maxrev
in: query
description: The maximum number of codes to be returned under 'revenue-codes for lcd policies'
schema:
type: integer
format: int32
default: 200
- name: maxsupp
in: query
description: The maximum number of diagnostic codes to be returned under 'supporting-medical-necessity'
for lcd policies
schema:
type: integer
format: int32
default: 200
- name: contractor-part
in: query
description: 'Comma seperated list of - ALL : Contractors for all of the parts below
- A
: Contractor for Part A policies
- B : Contractor for Part B policies
- DME : Contractor
for DME policies
'
schema:
type: string
default: ALL
example: ALL
- name: contractor-type
in: query
description: 'Comma seperated list of - ALL : All of the following types of contractors
- CA :
Carriers
- DA : DME MAC
- DP : DME PSC
- FI : Fiscal Intermediary
- MA :
MAC Part A
- MB : MAC Part B
- NA : National Part A
- NB : National Part
B
- ND : National DME
'
schema:
type: string
default: ALL
example: ALL
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorPolicyDetails'
example:
policyInfo:
title: NCD for Injection Sclerotherapy for Esophageal Variceal Bleeding (100.10)
effectiveDate: '1984-10-29T00:00:00.000Z'
url: http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?ncdid=95&ver=1
contractorNum: '0'
cmsId: '100.10'
contractorPart: A
contractorType: NA
icpPolicyId: 258971
policyType: NCD
ncdCodingInformation:
procedureCodes:
codeInfo:
- code: '43204'
description: Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal
varices
type: cpt
- code: '43243'
description: Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis
of esophageal/gastric varices
type: cpt
numcodes: 2
toomanycodes: false
diagnosticCodes:
covered:
codeInfo: []
denied:
codeInfo: []
notSupportingMedicalNecessity:
codeInfo: []
'400':
description: ContractorNum is larger than 5 characters
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorPolicyDetails'
example:
error:
- ContractorNum is larger than 5 characters
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Policy 'A9999' does not exist for Contractor '%04111'
content:
application/json:
schema:
$ref: '#/components/schemas/ContractorPolicyDetails'
example:
error:
- Policy 'A9999' does not exist for Contractor '04111'
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
/contractors/regions:
get:
tags:
- LCD
summary: Medicare contractor region list
operationId: getRegions
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Regions'
example:
region:
- value: Alaska
regionCode: AK
- value: Alabama
regionCode: AL
'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
/datafile/list:
get:
tags:
- Data File
summary: Data File List
operationId: getDatafileList
responses:
'200':
description: Successful Response
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/datafile/file/optum_cpc_base_2017_07
value: OPTUM_CPC_BASE_2017_07, Effective on 04/01/2018
- href: /ws/datafile/file/optum_cpc_base_2017_10_update
value: OPTUM_CPC_BASE_2017_10_update, Effective on 04/01/2018
'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
/datafile/file/{fileReqName}:
get:
tags:
- Data File
summary: Data File
operationId: getFile
parameters:
- name: fileReqName
in: path
description: The name of the file
required: true
schema:
type: string
example: optum_cpc_base_2017_07
- name: If-Modified-Since
in: header
description: The date last modified
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/octet-stream:
schema:
$ref: '#/components/schemas/Response'
example: default 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
/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}/all:
get:
tags:
- Revenue Code
summary: Show properties for Revenue Code
operationId: getReveunueCodesList
parameters:
- name: codetype
in: path
description: The type needed to identify
required: true
schema:
type: string
enum:
- revenue
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/RevCodeDesc'
example:
item:
- '0000'
- '0001'
- '0002'
- '0003'
'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/drg/{code}/properties:
get:
tags:
- DRG Codes
summary: Return Index search results
operationId: getProperty_1
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: '021'
- name: data
in: query
description: 'Comma seperated list of any of the following- desc-full : full description
- icd9 or icd10 : optional = icd9 default
- mdc : MDC value
- mdc-desc :
MDC Description
- med-surg : MED/SURG value
- gm-los : GMLOS value
- am-los :
AMLOS value
- rw : Relative Weight value
- np : National Payment
value
'
schema:
type: string
default: desc-full
example: desc-full
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/DrgCodeDesc'
example:
descFull: Intracranial Vascular Procedures with Principal Diagnosis of Hemorrhage with
CC
codeType: icd9
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/DrgCodeDesc'
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: No Drg code description found
content:
application/json:
schema:
$ref: '#/components/schemas/DrgCodeDesc'
example:
error: []
warning: []
info:
- No Drg code description found for the given Drg code you 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
/hcctype/{hccType}/{hccCode}:
get:
tags:
- HCC Information
summary: Returns all the Diagnosis Codes for the supplied HCC Code
operationId: getDiagList
parameters:
- name: hccType
in: path
description: Value for hccType
required: true
schema:
type: string
enum:
- cms-hcc
- cms-hcc-esrd-pace
- rx-hcc
- name: hccCode
in: path
description: Value for hccCode
required: true
schema:
type: string
example: HCC1
- name: modelCategory
in: query
description: cms-hcccms-hcc-esrd-pace
rx-hcc
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/DiagnosisCodeList'
example:
cmsHccV22:
- code: '042'
desc: Human immunodeficiency virus [HIV]
- code: '079.53'
desc: Human immunodeficiency virus, type 2 (HIV 2), in conditions classified elsewhere
and of unspecified site
cmsHccV12:
- code: '042'
desc: Human immunodeficiency virus [HIV]
- code: '079.53'
desc: Human immunodeficiency virus, type 2 (HIV 2), in conditions classified elsewhere
and of unspecified site
- code: V08
desc: Asymptomatic human immunodeficiency virus (HIV) infection status
cmsHccEsrdPace: []
rxHccV04: []
rxHcc: []
'400':
description: The provided code is not a valid HCC code
content:
application/json:
schema:
$ref: '#/components/schemas/DiagnosisCodeList'
example:
error:
- Not a valid HCC Code for the cms-hcc type
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: No Drg code description found
content:
application/json:
schema:
$ref: '#/components/schemas/DiagnosisCodeList'
example:
error: []
warning: []
info:
- No Drg code description found for the given Drg code you 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
/codetype/{codetype}/{code}/hcc:
get:
tags:
- HCC Information
summary: Returns the HCC Data for I9V1/I10CM Code
operationId: getI9I10HccData
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- icd9v1
- icd10cm
- name: code
in: path
description: The value of the code
required: true
schema:
type: string
example: '042'
- name: yyyy-mm-dd
in: header
description: Date needed for HCC Web Services
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Hcc'
example:
cmsHccV22:
- hccCode: HCC1
desc: HIV/AIDS
cmsHccV12:
- hccCode: HCC1
desc: HIV/AIDS
cmsHccEsrdPace:
- hccCode: HCC1
desc: HIV/AIDS
rxHccV04: []
rxHcc:
- hccCode: RXHCC1
desc: HIV/AIDS
'400':
description: The provided code is not a valid icd9v1/icd10cm code
content:
application/json:
schema:
$ref: '#/components/schemas/Hcc'
example:
error:
- The provided code is not a valid icd9v1/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: HCC Data does not exist for the particular icd9v1/icd10cm code
content:
application/json:
schema:
$ref: '#/components/schemas/Hcc'
example:
error:
- HCC Data does not exist for the particular icd9v1/icd10cm code
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
/hcctype/{hccType}:
get:
tags:
- HCC Information
summary: Returns all the HCC Codes for the supplied HCC Type
operationId: getHccData
parameters:
- name: hccType
in: path
description: Value for hccType
required: true
schema:
type: string
enum:
- cms-hcc
- cms-hcc-esrd-pace
- rx-hcc
- name: modelCategory
in: query
description: cms-hcccms-hcc-esrd-pace
rx-hcc
schema:
type: string
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Hcc'
example:
cmsHccV22:
- hccCode: HCC1
desc: HIV/AIDS
href: /ws/hcctype/cms-hcc/HCC1
cmsHccV12:
- hccCode: HCC1
desc: HIV/AIDS
href: /ws/hcctype/cms-hcc/HCC1
cmsHccEsrdPace: []
rxHccV04: []
rxHcc: []
'400':
description: Not a valid HCC Code for the cms-hcc type
content:
application/json:
schema:
$ref: '#/components/schemas/Hcc'
example:
error:
- Not a valid HCC Code for the cms-hcc type
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: No Diagnosis Code found for the HCC Code entered
content:
application/json:
schema:
$ref: '#/components/schemas/Hcc'
example:
error: []
warning: []
info:
- No Diagnosis Code found for the HCC Code 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
/hcctype:
get:
tags:
- HCC Information
summary: Show HyperLinks to valid HCC types
operationId: getHCCTypes
responses:
'200':
description: Successful Response
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/hcctype/cms-hcc
value: cms-hcc
- href: /ws/hcctype/cms-hcc-esrd-pace
value: cms-hcc-esrd-pace
- href: /ws/hcctype/rx-hcc
value: rx-hcc
'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
/codetype/{codetype}/{code}/icd10mapping:
get:
tags:
- ICD10 Mapping
summary: Return ICD-10 Mapping for the given ICD-9-V1 or ICD-9-V3 {code}
operationId: getI10Mapping
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- icd9v1
- icd9v3
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 314.2
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10Mapping'
example:
node:
- code: 08J0XZZ
desc: Inspection of Right Eye, External Approach
tips: GEM
premierPick: N
billTogether: N
href: /ws/codetype/icd10pcs/08J0XZZ
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10Mapping'
example:
error:
- The code provided ('5.31') 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 does not have ICD-10 Mapping
content:
application/json:
schema:
$ref: '#/components/schemas/Icd10Mapping'
example:
error:
- The Code '315.3' does not have ICD-10 Mapping
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}/icd9mapping:
get:
tags:
- ICD9 Mapping
summary: Backward Mapping to ICD-9-CM Vol-1 or ICD-9-CM Vol-3 Codes
operationId: getI9Mapping
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- icd10cm
- icd10pcs
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: F90.9
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Icd9Mapping'
example:
node:
- code: '314.00'
desc: Attention deficit disorder of childhood without mention of hyperactivity
tips: GEM
premierPick: N
billTogether: N
href: /ws/codetype/icd9v1/314.00
- code: '314.01'
desc: Attention deficit disorder of childhood with hyperactivity
tips: GEM
premierPick: Y
billTogether: N
href: /ws/codetype/icd9v1/314.01
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Icd9Mapping'
example:
error:
- The code provided ('5.31') in this web service request is not a valid 'icd10pcs' 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}/medicarepolicy/{policytype}{contractortype}:
get:
tags:
- Medicare Policy
summary: Get Medicare contractors info
operationId: getContractorLinks
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd10cm
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 99213
- name: policytype
in: path
description: Type of policy
required: true
schema:
type: string
enum:
- lcd
- ncd
- name: contractortype
in: path
description: '- LCD policy contractor types:
- ''fi'' - Part A Contractors (e.g.
Fiscal Intermediary)
- ''ca'' - Part B Contractors (e.g. Carrier)
- ''all''
- list of all contractors
- NCD policy contractor types:
- ''na'' - part A
- ''nb'' - part B
- ''all'' - includes part A and part B
'
required: true
schema:
pattern: (/([all|fi|ca|nb|na],*)+)?
type: string
default: all
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Contractors'
example:
type:
link:
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/all
value: ALL
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/ca
value: CA
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/fi
value: FI
'400':
description: Code does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/Contractors'
example:
error:
- Code '99999' does not exist
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: 'Wrong codetype '
content:
application/json:
schema:
$ref: '#/components/schemas/Contractors'
example:
error:
- The code provided ('250.01') in this web service request is not a valid 'cpt' code.
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}/medicarepolicy/{policytype}/{contractortype}/{contractornum}:
get:
tags:
- Medicare Policy
summary: Medicare Policies Data
operationId: getPolicies_1
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd10cm
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 83550
- name: policytype
in: path
description: Type of policy
required: true
schema:
type: string
enum:
- ncd
- lcd
- name: contractornum
in: path
description: A Valid 5 digit contractor number for LCD contractors or '0' for NCD contractors
required: true
schema:
type: string
example: 0
- name: contractortype
in: path
description: 'Local Coverage Determination(LCD)- ''ca'' : MAC Part B/Part B Carrier
- ''da'' :
Durable Medical Equipment(DME) Contractor
- ''fi'' : MAC Part A/Part A Fiscal Intermediary
National
Coverage Determination(NCD)- ''na'' : Medicare Part A
- ''nb'' : Medicare Part
B
- ''nd'' : Durable Medical Equipment(DME)
'
required: true
schema:
pattern: fi|ca|da|nb|na|nd
type: string
default: nb
- name: data
in: query
description: 'One of - ''active'' : Retrieve only active policies
- ''includeretired''
: Retrieve active and retired policies
'
schema:
type: string
default: active
- name: start
in: query
description: The index to start with
schema:
type: integer
format: int32
default: 0
- name: maxresults
in: query
description: The maximum number od results to be returned
schema:
type: integer
format: int32
default: 100
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Policies'
example:
type:
link:
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/all
value: ALL
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/ca
value: CA
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/fi
value: FI
'400':
description: '''Start'' value is negative'
content:
application/json:
schema:
$ref: '#/components/schemas/Policies'
example:
error:
- '''start'' value is negative.'
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/Policies'
example:
error:
- Code '99999' 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}/medicarepolicy:
get:
tags:
- Medicare Policy
summary: Medicare Policies
operationId: getPolicyLinks
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd9v1
- icd10cm
- 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:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/all
value: All LCD contractors
- href: /ws/codetype/cpt/99213/medicarepolicy/lcd/fi
value: FI (part A)
'400':
description: Wrong codetype
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
error:
- The code provided ('250.00') 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:
type: array
items:
$ref: '#/components/schemas/Link'
example:
error:
- Code '99999' 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}/allmodifiers:
get:
tags:
- Modifiers
summary: Return all the Modifiers for the supplied {codeype}
operationId: getModifiers
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
responses:
'200':
description: Successful Response
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
- href: /ws/codetype/cpt/modifier/1P?types=all&data=all
value: 1P
- href: /ws/codetype/cpt/modifier/22?types=all&data=all
value: '22'
'400':
description: Invalid parameter passed
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Link'
example:
error:
- The code provided ('ALLMODIFIERS=CMS2') in this web service request is not a valid '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: 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
/modifier-51-exempt:
get:
tags:
- Modifiers
summary: Returns the list of Optum/AMA Modifier -51 Exempt codes
operationId: getOptumAmaMod51Exempt
parameters:
- name: types
in: query
description: 'Comma seperated list of - optum : Optum -51 Exempt Modifiers
- ama
: AMA -51 Exempt Modifiers
'
schema:
type: string
default: optum,ama
example: optum,ama
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Modifier51Exempt'
example:
optum360:
- code: '90281'
description: Immune globulin (Ig), human, for intramuscular use
- code: '90283'
description: Immune globulin (IgIV), human, for intravenous use
'400':
description: Bad Types Parameter
content:
application/json:
schema:
type: array
items:
$ref: '#/components/schemas/Modifier51Exempt'
example:
error:
- Bad types 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: 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}/modifier/{modifier}:
get:
tags:
- Modifiers
summary: Return codes and properties for the supplied {modifier} and {codetype}
operationId: getProperty_2
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- name: modifier
in: path
description: The modifier for a particular code
required: true
schema:
type: string
example: 24
- name: data
in: query
description: 'Comma seperated list of- desc : e.g. SDHD (hereditary paraganglioma)
- usage
: eg. (Genetic testing code modifier. First digit is the disease category and the second is
the gene type. Report only when required by the payer. Genetic code modifiers may be reported
with CPT codes 83890-83916, 88230-88299 or other molecular and cytogenic studies.)
- def
: eg. The unavailability of a qualified resident surgeon is a prerequisite for use of modifier
82 appended to the usual procedure code number(s).
- source : eg. CMS Policy
- sourcing_rationale
: eg. Sourcing Rationale: 589 Current Procedural Terminology (CPT) Level I Modifiers and Healthcare
Common Procedure Coding System (HCPCS) Level II modifiers are appended to Level I or Level II
Codes based on information from the Centers.... (can be long)
- all : All of the above
data.
'
schema:
type: string
default: desc
example: desc,usage
- name: types
in: query
description: 'comma seperated list of - physician : Physician modifiers
- facility
: Facility modifiers
- opps : Facility modifiers with OPPS
- asc : ASC Payment modifiers
- mpfs
: MPFS/Medicare modifiers
- ambulance: CMS Ambulatory modifiers
- dme: CMS Durable
Medical Equipment modifiers
- all: all modifiers
'
schema:
type: string
default: physician
example: physician,facility
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ModifierProperty'
example:
description: Unrelated Evaluation and Management Service by the Same Physician or Other
Qualified Health Care Professional During a Postoperative Period
physician:
link:
- href: /ws/codetype/cpt/92002
value: '92002'
- href: /ws/codetype/cpt/92004
value: '92004'
'400':
description: Unknown Type Element
content:
application/json:
schema:
$ref: '#/components/schemas/ModifierProperty'
example:
error:
- 'Unknown types element : faccility'
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Code not found for modifier entered
content:
application/json:
schema:
$ref: '#/components/schemas/ModifierProperty'
example:
error: []
warning: []
info:
- Code not found for the modifier 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
/codetype/modifier/{code}/properties:
get:
tags:
- Modifiers
summary: Show properties for modifier Code
operationId: getProperty_3
parameters:
- name: code
in: path
description: The modifier code to search
required: true
schema:
type: string
example: 22
- name: data
in: query
description: 'desc-full : full description'
schema:
type: string
default: desc-full
example: desc-full
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/ModifierDesc'
example:
descFull: Increased Procedural Services
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/ModifierDesc'
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: No modifier code description found
content:
application/json:
schema:
$ref: '#/components/schemas/ModifierDesc'
example:
error: []
warning: []
info:
- No modifier code description found for the given modifier code you 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
/codetype/{codetype}/{code}/modifiers:
get:
tags:
- Modifiers
summary: Return Modifiers for the supplied {code}. If you want additional information please supply
additional query parameters
operationId: getModifiers_1
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: 93886
- name: types
in: query
description: 'Comma seperated list of - physician : Physician modifiers (default)
- facility
: Facility modifiers
- opps : Facility modifiers with OPPS
- mpfs : MPFS/Medicare
modifiers
- asc: ASC Payment modifiers
- ambulance: CMS Ambulatory modifiers
- dme:
CMS Durable Medical Equipment modifiers
- all: all modifiers
'
schema:
type: string
default: physician
example: physician
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
physician:
link:
- href: /ws/codetype/cpt/modifier/93886
value: '22'
- href: /ws/codetype/cpt/modifier/93886
value: '23'
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
error:
- 'Unknown data element : faccility'
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: Modifiers not found for the code entered
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
error: []
warning: []
info:
- Modifiers not found for the code 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
/codetype/{codetype}/{code}/mpfs:
get:
tags:
- Code Fee
summary: List of Medicare Localities and links to them. This can be used to get MPFS data
operationId: getCarriers
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: 13100
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
- href: /ws/codetype/cpt/13100/mpfs/global-info
value: Medicare Global Information
- href: /ws/codetype/cpt/13100/mpfs/00000-00
value: NATIONAL
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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: Modifiers not found for the code entered
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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}/mpfs/{carrier-locality}/non-facility:
get:
tags:
- Code Fee
summary: Return all Medicare Physician non facility Fees
operationId: getFee
parameters:
- name: code
in: path
description: The code value for the respective codetype
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: carrier-locality
in: path
description: The carrier-localty value
required: true
schema:
type: string
example: 00000-00
- name: types
in: query
description: 'Comma seperated list of - fee : Medicare Physican fees (default)
- rvu
: Medicare Physician RVUs
'
schema:
type: string
default: fee
example: fee,rvu
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
mpfsFee:
global: '352.98'
mpfsRvu:
global:
totalRvu: '10.2000'
workRvu: '3.0000'
peRvu: '6.8500'
mpRvu: '0.3500'
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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: Carrier/Locality length is incorrect
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
error: []
warning: []
info:
- Carrier/Locality length is incorrect. Please use the Carriers web service to check your
entry.
'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}/mpfs/global-info:
get:
tags:
- Code Fee
summary: Return all Medicare Global information for the supplied {code}
operationId: getGlobal
parameters:
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: G0168
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- hcpcs
- cpt
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
preoperative: '0.10'
intraoperative: '0.80'
postoperative: '0.10'
global: '010'
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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: The requested resource does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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}/mpfs/{locality}:
get:
tags:
- Code Fee
summary: Links to data available for the locality
operationId: getMpfsLinks
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: 13100
- name: locality
in: path
description: The value for locality
required: true
schema:
pattern: '[0-9][0-9][0-9][0-9][0-9]-[0-9][0-9]'
type: string
example: 10102-00
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
example:
- href: /ws/codetype/cpt/13100/mpfs/10102-00/non-facility
value: Medicare Physician Fees/RVUs
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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: Code {code} does not exist
content:
application/json:
schema:
$ref: '#/components/schemas/Modifiers'
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
/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}/annotations:
get:
tags:
- Reference Code
summary: Return Annotations for the given hcpcs/icd9v1 {code}
operationId: getAnnotations
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- hcpcs
- icd9v1
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: A0021
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/Items'
example:
item:
- This code represents a per mile charge for ambulance transportation outside of the state
where the ambulance provider is based and is reported only for Medicaid claims. Consult
the local Medicaid office in the state that the provider is located for further definition
and usage requirements.
'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}/includesexcludesnotes:
get:
tags:
- Reference Code
summary: Return includes/excludes notes for the given code {code}
operationId: getIncludesExcludesNotes
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- icd9v1
- icd9v3
- icd10cm
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: 210
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/IncludesExcludesNotes'
example:
includesNotes:
note: []
excludesNotes:
excludesHeader: 'cyst (of):'
note:
- content: oral soft tissue (528.4)
indentation: 1
- content: radicular (522.8)
indentation: 1
'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}/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}/optum-specialty-articles:
get:
tags:
- Optum Specialty Articles
summary: Show Articles for Optum Specialty
operationId: getCodes_1
parameters:
- name: code
in: path
description: The code value
required: true
schema:
type: string
example: 13100
- name: codetype
in: path
description: The code value
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- icd10cm
- icd10pcs
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/OptumSpecialtyArticles'
example: " {\n \"code\": \"99213\",\n \"year\": \"2024\",\n \
\ \"issue\": \"January\",\n \"source\": \"1995 and 1997 Documentation\
\ Guidelines www.cms.gov and the Marshfield E/M Scoring tool used by Novitas-Solutions\
\ (http://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyd?_afrLoop=142131956577316&_adf.ctrl-state=qolq8oej1_63&contentId=00004968#)\"\
,\n \"article_title\": \"What Is the Risk In Medical Decision-Making Scoring?\"\
,\n \"date\": \"\t02/23/2024\",\n \"abstract\": \"Medical decision-making\
\ is another key component used to document an E/M level of service. This component includes\
\ three areas of which two must be met to satisfy the appropriate level of service, One\
\ of which is the level of risk.\",\n \"article_text\": \"The third key\
\ component of an evaluation and management (E/M) service is medical decision-making (MDM).\
\ This is often the information found in the assessment and plan portion of a SOAP note\
\ (Subjective, Objective, Assessment, and Plan). The SOAP format is familiar to physicians\
\ as this is how they will often format their notes when documenting their patient visits.\
\ .
\",\n } "
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/OptumSpecialtyArticles'
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: No Optum Specialty Article Codes were found
content:
application/json:
schema:
$ref: '#/components/schemas/OptumSpecialtyArticles'
example:
error: []
warning: []
info:
- No Optum Specialty Article Codes were 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}/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:
\r\
\n\r\n- Episode of care - Initial, subsequent, sequela
\r\n\r\n- Initial\
\ encounter - patient is receiving active treatment for the fracture
\r\n\r\
\n- Examples - surgical treatment, emergency department encounter, evaluation by\
\ new physician
\r\n- Subsequent encounter - patient has completed active\
\ treatment for the condition
\r\n\r\n- Examples - cast change/removal,\
\ medication adjustment, followup visits
\r\n- Sequela - complications\
\ or conditions that arise as a direct result of a condition
\r\n\r\n\
- 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.
\r\n- Open or closed fracture
\r\n\r\
\n- If open, Type I or Type II (Gustillo classification)
\r\n- If open, Type\
\ IIIA, IIIB, or IIIC
\r\n- Healing
\r\n\r\n- Routine healing
\r\
\n- Delayed healing
\r\n- Malunion
\r\n- Nonunion
\r\n\
"
'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
/codetype/revenue/{code}/properties:
get:
tags:
- Revenue Code
summary: Show properties for Revenue Code
operationId: getProperty_4
parameters:
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: '0250'
- name: data
in: query
description: 'Comma seperated list of any of the following- desc-35 : up to 35 character
description
- desc-48 : up to 48 character description
- desc-255 : up to 255
character description
- desc-full : full description
'
schema:
type: string
default: desc-full
example: desc-full
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/RevCodeDesc'
example:
desc35: Pharmacy-General Classification
'400':
description: Bad data parameter
content:
application/json:
schema:
$ref: '#/components/schemas/RevCodeDesc'
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: No revenue code description found
content:
application/json:
schema:
$ref: '#/components/schemas/RevCodeDesc'
example:
error: []
warning: []
info:
- No revenue code description found for the given revenue code you 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
/codetype/{codetype}/{code}/revenuecodes:
get:
tags:
- Revenue Code
summary: Return CPT/HCPCS to Revenue code crosswalk for the given cpt/hcpcs {code}
operationId: getRevenueCodes
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
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/PhysicianDocs'
example:
item:
- revCode: '0456'
revCodeDesc: Emergency Room-Urgent Care
tobFacilityCode: '013'
tobFacilityCodeDesc: Hospital Outpatient
note: Clinic or ED Visit. Paid a separate APC.
'400':
description: Wrong codetype
content:
application/json:
schema:
$ref: '#/components/schemas/PhysicianDocs'
example:
error:
- The code provided ('9999') 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: Revenue code crosswalk not found
content:
application/json:
schema:
$ref: '#/components/schemas/PhysicianDocs'
example:
error: []
warning: []
info:
- Revenue code crosswalk not found for the code (99999) 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
/codetype/{codetype}/{code}/{xwalkcodetype}:
get:
tags:
- Revenue Code
summary: Rev Codes to CPT/HCPCS Crosswalk
operationId: getprocCodes
parameters:
- name: codetype
in: path
description: The codetype needed to identify the type of code
required: true
schema:
type: string
enum:
- revenue
- name: code
in: path
description: The code value for the respective codetype
required: true
schema:
type: string
example: '0250'
- name: xwalkcodetype
in: path
description: 'The xwalkcodetype value '
required: true
schema:
type: string
enum:
- cpt
- hcpcs
- name: start
in: query
description: start parameter must be a non negative value and default value is 0
schema:
type: integer
format: int32
default: 0
- name: maxresults
in: query
description: maxresults parameter must be a non negative value and default value is 100
schema:
type: integer
format: int32
default: 100
responses:
'200':
description: Successful Response
content:
application/json:
schema:
$ref: '#/components/schemas/RevenueCodeToProcedure'
example:
item:
- code: '90296'
desc: Diphtheria antitoxin, equine, any route
tobFacilityCode: '013'
tobFacilityCodeDesc: Hospital Outpatient
note: This code is not covered by Medicare when submitted on any outpatient claim.
link: []
'400':
description: Start value is negative
content:
application/json:
schema:
$ref: '#/components/schemas/RevenueCodeToProcedure'
example:
error:
- Start value is negative.
warning: []
info: []
'401':
description: Not Authorized
content:
application/json:
example:
timestamp: '2022-07-06T16:34:39.385Z'
error: Unauthorized
status: 401
'404':
description: No cpt/hcps crosswalk codes found
content:
application/json:
schema:
$ref: '#/components/schemas/RevenueCodeToProcedure'
example:
error: []
warning: []
info:
- No cpt/hcps crosswalk codes found for the given revenue code you 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
/application.wadl/{path}:
get:
operationId: getExternalGrammar
parameters:
- name: path
in: path
required: true
schema:
type: string
responses:
default:
description: default response
content:
application/xml: {}
/application.wadl:
get:
operationId: getWadl
responses:
default:
description: default response
content:
application/vnd.sun.wadl+xml: {}
application/xml: {}
components:
schemas:
Items:
type: object
properties:
item:
type: array
items:
type: string
xml:
name: items
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
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
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
Cdi:
required:
- cdiDoc
type: object
properties:
cdiDoc:
type: array
xml:
name: cdi-doc
items:
$ref: '#/components/schemas/CdiDoc'
xml:
name: cdi
CdiDoc:
type: object
properties:
url:
type: string
pdftitle:
type: string
sourcetitle:
type: string
associatedcodes:
type: string
ClaimLineEdit:
required:
- description
- editConflict
- editType
- mnemonic
type: object
properties:
description:
type: string
editConflict:
type: string
xml:
name: edit-conflict
editType:
type: string
xml:
name: edit-type
mnemonic:
type: string
line:
type: integer
format: int32
xml:
attribute: true
ClaimResponse:
type: object
properties:
edit:
type: array
items:
$ref: '#/components/schemas/ClaimLineEdit'
claimId:
type: string
xml:
name: claim-id
attribute: true
ClaimResponses:
required:
- claimResponse
type: object
properties:
claimResponse:
type: array
xml:
name: claim-response
items:
$ref: '#/components/schemas/ClaimResponse'
xml:
name: claim-responses
Claim:
required:
- dateOfBirth
type: object
properties:
clientClaimIdentifier:
type: string
xml:
name: id
attribute: true
dateOfService:
type: string
format: date-time
xml:
name: service-date
dateOfBirth:
type: string
format: date-time
xml:
name: birth-date
gender:
type: string
enum:
- Male
- Female
taxonomy:
type: string
payer:
type: string
claimLineList:
type: array
items:
$ref: '#/components/schemas/ClaimLine'
claimOrder:
type: integer
format: int32
providerSpeciality:
type: string
engineClaim:
$ref: '#/components/schemas/PhysicianClaim'
xml:
name: claim
ClaimLine:
type: object
properties:
lineNumber:
type: integer
format: int32
dateOfServiceBegin:
type: string
format: date-time
xml:
name: service-begin-date
dateOfServiceEnd:
type: string
format: date-time
xml:
name: service-end-date
procedureCode:
type: string
xml:
name: procedure-code
modifiers:
type: array
items:
type: string
diagnosticType:
type: string
xml:
name: diagnostic-type
attribute: true
enum:
- ICD_9_V_1
- ICD_10_CM
diagnosticCodes:
type: array
xml:
name: diagnostic-code
items:
type: string
xml:
name: diagnostic-code
placeOfService:
type: string
xml:
name: place-of-service
units:
type: integer
format: int32
i9V1Codes:
type: array
items:
type: string
allDiagCodes:
type: array
items:
type: string
engineClaimLine:
$ref: '#/components/schemas/ClaimLine'
xml:
name: claim-line
PhysicianClaim:
type: object
properties:
clientClaimIdentifier:
type: string
dateOfService:
type: string
format: date-time
dateOfBirth:
type: string
format: date-time
gender:
type: string
enum:
- Male
- Female
taxonomy:
type: string
payer:
type: string
claimLineList:
type: array
items:
$ref: '#/components/schemas/ClaimLine'
nationalProviderId:
type: string
providerSpeciality:
type: string
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'
CodeHistoryReferences:
type: object
properties:
notInAmaBook:
type: string
xml:
name: NotInAmaBook
retroactive:
type: string
xml:
name: Retroactive
CompleteCodeHistory:
required:
- codeHistory
type: object
properties:
codeHistory:
type: array
xml:
name: code-history
items:
$ref: '#/components/schemas/CodeHistory'
xml:
name: complete-code-history
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
ColorCodes:
required:
- modifier51Exempt
type: object
properties:
newCode:
type: string
xml:
name: new-code
revisedCode:
type: string
xml:
name: revised-code
reinstatedCode:
type: string
xml:
name: reinstated-code
resequencedCode:
type: string
xml:
name: resequenced-code
optumAddonCode:
type: string
xml:
name: optum-addon-code
modifier51Exempt:
type: array
xml:
name: modifier-51-exempt
items:
type: string
xml:
name: modifier-51-exempt
maleProcedure:
type: string
xml:
name: male-procedure
femaleProcedure:
type: string
xml:
name: female-procedure
unlistedCode:
type: string
xml:
name: unlisted-code
ascPaymentIndicator:
type: string
xml:
name: asc-payment-indicator
ascPaymentIndicatorDescription:
type: string
xml:
name: asc-payment-indicator-description
moderateSedation:
type: string
xml:
name: moderate-sedation
medicalUnlikelyEdits:
type: string
xml:
name: medical-unlikely-edits
ageRestrictions:
type: string
xml:
name: age-restrictions
maternity:
type: string
modifier63Exempt:
type: string
xml:
name: modifier-63-exempt
addOn:
type: string
xml:
name: add-on
serviceNotCoveredByMedicare:
type: string
xml:
name: service-not-covered-by-medicare
opsiCode:
type: string
xml:
name: opsi-code
coSurgeryAllowed:
type: string
xml:
name: co-surgery-allowed
assistAtSurgeryAllowedWithDocumentation:
type: string
xml:
name: assist-at-surgery-allowed-with-documentation
assistAtSurgeryAllowed:
type: string
xml:
name: assist-at-surgery-allowed
cliaWavedTest:
type: string
xml:
name: clia-waved-test
carrierPriced:
type: string
xml:
name: carrier-priced
teamSurgeryAllowed:
type: string
xml:
name: team-surgery-allowed
mulitplePxReductionGuidelinesApply:
type: string
xml:
name: mulitple-px-reduction-guidelines-apply
endoscopicMultiplePxGuidelinesApply:
type: string
xml:
name: endoscopic-multiple-px-guidelines-apply
bilateralSurgeryAllowed:
type: string
xml:
name: bilateral-surgery-allowed
stvxPackaged:
type: string
xml:
name: stvx-packaged
bloodAndBloodProducts:
type: string
xml:
name: blood-and-blood-products
brachytherapySources:
type: string
xml:
name: brachytherapy-sources
mayBePaidThroughCompositeApc:
type: string
xml:
name: may-be-paid-through-composite-apc
contractorDiscretion:
type: string
xml:
name: contractor-discretion
notCoveredOrValidForMedicare:
type: string
xml:
name: not-covered-or-valid-for-medicare
quantityAlert:
type: string
xml:
name: quantity-alert
specialCoverageInstructions:
type: string
xml:
name: special-coverage-instructions
digitRequired4Th:
type: string
xml:
name: digit-required-4th
digitRequired5Th:
type: string
xml:
name: digit-required-5th
maleDiagnosis:
type: string
xml:
name: male-diagnosis
femaleDiagnosis:
type: string
xml:
name: female-diagnosis
unspecifiedDiagnosisCode:
type: string
xml:
name: unspecified-diagnosis-code
otherSpecifiedDiagnosisCode:
type: string
xml:
name: other-specified-diagnosis-code
adultDiagnosis:
type: string
xml:
name: adult-diagnosis
maternityDiagnosis:
type: string
xml:
name: maternity-diagnosis
newbornDiagnosis:
type: string
xml:
name: newborn-diagnosis
pediatricDiagnosis:
type: string
xml:
name: pediatric-diagnosis
hivRelated:
type: string
xml:
name: hiv-related
duplicatePrimaryDx:
type: string
xml:
name: duplicate-primary-dx
unacceptablePrincipalDx:
type: string
xml:
name: unacceptable-principal-dx
manifestationCodeNotAPrimaryDx:
type: string
xml:
name: manifestation-code-not-a-primary-dx
comorbidityOrComplication:
type: string
xml:
name: comorbidity-or-complication
majorComplication:
type: string
xml:
name: major-complication
reviseNoteNotBook:
type: string
xml:
name: revisedcode-note-not-ama-book
newCptNotAmaBook:
type: string
xml:
name: newcptcode-not-ama-book
modifier95:
type: string
xml:
name: modifier-95
tpackaged:
type: string
vcodeAsPrimaryDx:
type: string
xml:
name: color-codes
Link:
type: object
properties:
href:
type: string
xml:
attribute: true
value:
type: string
Icd10CmColorCodes:
type: object
properties:
newCode:
type: string
xml:
name: new-code
revisedCode:
type: string
xml:
name: revised-code
characterRequired4Th:
type: string
xml:
name: character-required-4th
characterRequired5Th:
type: string
xml:
name: character-required-5th
characterRequired6Th:
type: string
xml:
name: character-required-6th
characterRequired7Th:
type: string
xml:
name: character-required-7th
characterRequiredX7Th:
type: string
xml:
name: character-required-x7th
maleDiagnosis:
type: string
xml:
name: male-diagnosis
femaleDiagnosis:
type: string
xml:
name: female-diagnosis
unspecifiedDiagnosisCode:
type: string
xml:
name: unspecified-diagnosis-code
otherSpecifiedDiagnosisCode:
type: string
xml:
name: other-specified-diagnosis-code
adultDiagnosis:
type: string
xml:
name: adult-diagnosis
maternityDiagnosis:
type: string
xml:
name: maternity-diagnosis
newbornDiagnosis:
type: string
xml:
name: newborn-diagnosis
pediatricDiagnosis:
type: string
xml:
name: pediatric-diagnosis
hivRelated:
type: string
xml:
name: hiv-related
unacceptablePrincipalDx:
type: string
xml:
name: unacceptable-principal-dx
manifestationCodeNotAPrimaryDx:
type: string
xml:
name: manifestation-code-not-a-primary-dx
comorbidityOrComplication:
type: string
xml:
name: comorbidity-or-complication
majorComplication:
type: string
xml:
name: major-complication
questionablePdx:
type: string
xml:
name: questionable-pdx
hospitalAcquiredCondition:
type: array
xml:
name: hospital-acquired-condition
items:
type: string
xml:
name: hospital-acquired-condition
conditionalHospitalAcquiredCondition:
type: array
xml:
name: conditional-hospital-acquired-condition
items:
type: string
xml:
name: conditional-hospital-acquired-condition
zcodeIndicator:
type: string
xml:
name: icd-10-cm-color-codes
Icd10pcsColorCodes:
type: object
properties:
newCode:
type: string
xml:
name: new-code
revisedCode:
type: string
xml:
name: revised-code
maleDiagnosis:
type: string
xml:
name: male-diagnosis
femaleDiagnosis:
type: string
xml:
name: female-diagnosis
mappingToIcd9Code:
type: string
xml:
name: mapping-to-icd9-code
procedureInconsistentLOS:
type: string
xml:
name: procedure-inconsistent-los
nonCoveredByMedicare:
type: string
xml:
name: noncovered-medicare
nonORProcedure:
type: string
xml:
name: non-OR-procedure
limitedCoverageProcedure:
type: string
xml:
name: icd-10-pcs-color-codes
EntityTag:
type: object
properties:
value:
type: string
weak:
type: boolean
MediaType:
type: object
properties:
type:
type: string
subtype:
type: string
parameters:
type: object
additionalProperties:
type: string
wildcardType:
type: boolean
wildcardSubtype:
type: boolean
MultivaluedMapStringObject:
type: object
properties:
empty:
type: boolean
additionalProperties:
type: array
items:
type: object
MultivaluedMapStringString:
type: object
properties:
empty:
type: boolean
additionalProperties:
type: array
items:
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
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
StatusType:
type: object
properties:
reasonPhrase:
type: string
family:
type: string
enum:
- INFORMATIONAL
- SUCCESSFUL
- REDIRECTION
- CLIENT_ERROR
- SERVER_ERROR
- OTHER
statusCode:
type: integer
format: int32
UriBuilder:
type: object
Icd10CmCodeSpecificGuideline:
type: object
properties:
year:
type: string
title:
type: string
guideline:
type: string
Icd10CmCodeSpecificGuidelines:
type: object
properties:
icd10CmCodeSpecificGuideline:
type: array
xml:
name: icd-10-cm-code-specific-guideline
items:
$ref: '#/components/schemas/Icd10CmCodeSpecificGuideline'
xml:
name: icd-10-cm-code-specific-guidelines
Icd10pcsCodeSpecificGuideline:
type: object
properties:
year:
type: string
title:
type: string
guideline:
type: string
Icd10pcsCodeSpecificGuidelines:
required:
- icd10pcsCodeSpecificGuideline
type: object
properties:
icd10pcsCodeSpecificGuideline:
type: array
xml:
name: icd-10-pcs-code-specific-guideline
items:
$ref: '#/components/schemas/Icd10pcsCodeSpecificGuideline'
xml:
name: icd-10-pcs-code-specific-guidelines
IndexSearchResult:
type: object
properties:
term:
type: string
level:
type: integer
format: int64
codes:
type: string
IndexSearchResults:
required:
- indexSearchResult
type: object
properties:
indexSearchResult:
type: array
xml:
name: index-search-result
items:
$ref: '#/components/schemas/IndexSearchResult'
xml:
name: index-search-results
CodeRange:
type: object
properties:
headers:
type: string
rangeId:
type: integer
format: int32
xml:
name: range-id
rangeItem:
type: array
xml:
name: range-item
items:
$ref: '#/components/schemas/RangeItem'
link:
type: array
items:
$ref: '#/components/schemas/Link'
xml:
name: code-range
RangeItem:
type: object
properties:
code:
type: string
description:
type: string
tabulardata:
$ref: '#/components/schemas/Tabulardata'
href:
type: string
xml:
attribute: true
Tabulardata:
type: object
properties:
dataLine:
type: array
xml:
name: data-line
items:
type: string
xml:
name: data-line
TermSearchResult:
required:
- code
type: object
properties:
code:
type: string
rank:
type: integer
format: int64
desc:
type: string
descFull:
type: string
xml:
name: desc-full
href:
type: string
xml:
attribute: true
codeType:
type: integer
format: int32
TermSearchResults:
type: object
properties:
termSearchResult:
type: array
xml:
name: term-search-result
items:
$ref: '#/components/schemas/TermSearchResult'
link:
type: array
items:
$ref: '#/components/schemas/Link'
xml:
name: term-search-results
Node:
required:
- code
type: object
properties:
node:
type: array
items:
$ref: '#/components/schemas/Node'
code:
type: string
rank:
type: integer
format: int64
desc:
type: string
descFull:
type: string
xml:
name: desc-full
href:
type: string
xml:
attribute: true
hrefBeg:
type: string
xml:
name: href-beg
attribute: true
hrefEnd:
type: string
xml:
name: href-end
attribute: true
TermSearchGroups:
type: object
properties:
termSearchGroup:
type: array
xml:
name: term-search-group
items:
$ref: '#/components/schemas/Node'
xml:
name: term-search-groups
CodingSupportResource:
required:
- code
- document
- referencedContentExample
- referencedDocumentType
- title
type: object
properties:
code:
type: string
referencedDocumentType:
type: string
xml:
name: referenced-document-type
title:
type: string
referencedContentExample:
type: string
xml:
name: referenced-content-example
document:
type: string
CodingSupportResources:
type: object
properties:
codingSupportResource:
type: array
items:
$ref: '#/components/schemas/CodingSupportResource'
xml:
name: codingSupportResources
Contractor:
required:
- contractorName
- contractorNumber
- contractorPart
- contractorType
- regionCode
- regionName
type: object
properties:
regionCode:
type: string
xml:
name: region-code
regionName:
type: string
xml:
name: region-name
contractorName:
type: string
xml:
name: contractor-name
contractorPart:
type: string
xml:
name: contractor-part
contractorType:
type: string
xml:
name: contractor-type
contractorNumber:
type: string
xml:
name: contractor-number
ContractorList:
required:
- contractor
type: object
properties:
contractor:
type: array
items:
$ref: '#/components/schemas/Contractor'
xml:
name: contractor-list
ContractorPolicies:
type: object
properties:
policy:
type: array
items:
$ref: '#/components/schemas/Policy'
xml:
name: contractor-policies
Policy:
type: object
properties:
status:
type: string
effectiveDate:
type: string
xml:
name: effective_date
endDate:
type: string
xml:
name: end_date
title:
type: string
url:
type: string
code:
type: string
cmsId:
type: string
xml:
attribute: true
CodeGroup:
type: object
properties:
paragraph:
type: string
codeInfo:
type: array
xml:
name: code-info
items:
$ref: '#/components/schemas/CodeInfo'
CodeInfo:
required:
- code
- description
type: object
properties:
code:
type: string
description:
type: string
type:
type: string
xml:
attribute: true
ContractorPolicyDetails:
required:
- policyInfo
type: object
properties:
policyInfo:
$ref: '#/components/schemas/PolicyInfo'
ncdCodingInformation:
$ref: '#/components/schemas/NcdCodingInformation'
lcdCodingInformation:
$ref: '#/components/schemas/LcdCodingInformation'
xml:
name: contractor-policy-details
Covered:
type: object
properties:
codeInfo:
type: array
xml:
name: code-info
items:
$ref: '#/components/schemas/CodeInfo'
numcodes:
type: integer
format: int32
xml:
attribute: true
toomanycodes:
type: boolean
xml:
attribute: true
Denied:
type: object
properties:
codeInfo:
type: array
xml:
name: code-info
items:
$ref: '#/components/schemas/CodeInfo'
numcodes:
type: integer
format: int32
xml:
attribute: true
toomanycodes:
type: boolean
xml:
attribute: true
DiagnosticCodes:
type: object
properties:
supportingMedicalNecessity:
$ref: '#/components/schemas/SupportingMedicalNecessity'
notSupportingMedicalNecessity:
$ref: '#/components/schemas/NotSupportingMedicalNecessity'
LcdCodingInformation:
type: object
properties:
typeOfBillCodes:
$ref: '#/components/schemas/TypeOfBillCodes'
revenueCodes:
$ref: '#/components/schemas/RevenueCodes'
procedureCodes:
$ref: '#/components/schemas/ProcedureCodes'
diagnosticCodes:
$ref: '#/components/schemas/DiagnosticCodes'
NcdCodingInformation:
type: object
properties:
procedureCodes:
$ref: '#/components/schemas/ProcedureCodes'
diagnosticCodes:
$ref: '#/components/schemas/DiagnosticCodes'
NotSupportingMedicalNecessity:
type: object
properties:
codeGroup:
type: array
xml:
name: code-group
items:
$ref: '#/components/schemas/CodeGroup'
numcodes:
type: integer
format: int32
xml:
attribute: true
toomanycodes:
type: boolean
xml:
attribute: true
PolicyInfo:
required:
- effectiveDate
- title
- url
type: object
properties:
title:
type: string
effectiveDate:
type: string
xml:
name: effective-date
expirationDate:
type: string
xml:
name: expiration-date
url:
type: string
contractorNum:
type: string
xml:
name: contractor-num
attribute: true
cmsId:
type: string
xml:
name: cms-id
attribute: true
contractorPart:
type: string
xml:
name: contractor-part
attribute: true
contractorType:
type: string
xml:
name: contractor-type
attribute: true
icpPolicyId:
type: integer
format: int32
policyType:
type: string
ProcedureCodes:
type: object
properties:
codeGroup:
type: array
xml:
name: code-group
items:
$ref: '#/components/schemas/CodeGroup'
numcodes:
type: integer
format: int32
xml:
attribute: true
toomanycodes:
type: boolean
xml:
attribute: true
RevenueCodes:
type: object
properties:
codeInfo:
type: array
xml:
name: code-info
items:
$ref: '#/components/schemas/CodeInfo'
SupportingMedicalNecessity:
type: object
properties:
codeGroup:
type: array
xml:
name: code-group
items:
$ref: '#/components/schemas/CodeGroup'
numcodes:
type: integer
format: int32
xml:
attribute: true
toomanycodes:
type: boolean
xml:
attribute: true
TypeOfBillCodes:
type: object
properties:
codeInfo:
type: array
xml:
name: code-info
items:
$ref: '#/components/schemas/CodeInfo'
Region:
type: object
properties:
value:
type: string
regionCode:
type: string
xml:
name: region-code
attribute: true
Regions:
type: object
properties:
region:
type: array
items:
$ref: '#/components/schemas/Region'
xml:
name: regions
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
IngenixCodersDictionary:
required:
- entry
type: object
properties:
entry:
type: array
items:
$ref: '#/components/schemas/Entry'
xml:
name: optum360-coders-dictionary
Drg:
required:
- code
- description
- mdc
- mdcDescription
- medSurg
type: object
properties:
code:
type: string
description:
type: string
mdc:
type: string
mdcDescription:
type: string
medSurg:
type: string
xml:
name: drg-cross-code
DrgList:
type: object
properties:
drg:
type: array
items:
$ref: '#/components/schemas/Drg'
xml:
name: drg-cross-code-list
DrgCodeDesc:
type: object
properties:
descFull:
type: string
xml:
name: desc-full
codeType:
type: string
xml:
name: code-type
mdc:
type: string
xml:
name: MDC
mdcDesc:
type: string
xml:
name: MDC-desc
medSurg:
type: string
xml:
name: med-surg
gmLos:
type: string
xml:
name: gm-los
amLos:
type: string
xml:
name: am-los
relativeWeight:
type: string
xml:
name: relative-weight
nationalPayment:
type: string
xml:
name: national-payment
xml:
name: code-properties
CmsHccEsrdPace:
type: object
properties:
hccCode:
type: string
xml:
name: hcc-code
desc:
type: string
href:
type: string
xml:
attribute: true
CmsHccV12:
type: object
properties:
hccCode:
type: string
xml:
name: hcc-code
desc:
type: string
href:
type: string
xml:
attribute: true
CmsHccV22:
type: object
properties:
hccCode:
type: string
xml:
name: hcc-code
desc:
type: string
href:
type: string
xml:
attribute: true
CmsHccVx:
type: object
properties:
hccCode:
type: string
xml:
name: hcc-code
desc:
type: string
href:
type: string
xml:
attribute: true
DiagnosisCodeList:
required:
- cmsHccEsrdPace
- cmsHccV12
- cmsHccV22
- cmsHccVx
- rxHcc
- rxHccV04
type: object
properties:
cmsHccV22:
type: array
xml:
name: cms-hcc-v22
items:
$ref: '#/components/schemas/CmsHccV22'
cmsHccVx:
type: array
xml:
name: cms-hcc-vx
items:
$ref: '#/components/schemas/CmsHccVx'
cmsHccV12:
type: array
xml:
name: cms-hcc-v12
items:
$ref: '#/components/schemas/CmsHccV12'
cmsHccEsrdPace:
type: array
xml:
name: cms-hcc-esrd-pace
items:
$ref: '#/components/schemas/CmsHccEsrdPace'
rxHccV04:
type: array
xml:
name: rx-hcc-v04
items:
$ref: '#/components/schemas/RxHccV04'
rxHcc:
type: array
xml:
name: rx-hcc
items:
$ref: '#/components/schemas/RxHcc'
xml:
name: diagnosis-code-list
RxHcc:
type: object
properties:
hccCode:
type: string
xml:
name: hcc-code
desc:
type: string
href:
type: string
xml:
attribute: true
RxHccV04:
type: object
properties:
hccCode:
type: string
xml:
name: hcc-code
desc:
type: string
href:
type: string
xml:
attribute: true
Hcc:
required:
- cmsHccEsrdPace
- cmsHccV12
- cmsHccV22
- rxHcc
- rxHccV04
type: object
properties:
cmsHccV22:
type: array
xml:
name: cms-hcc-v22
items:
$ref: '#/components/schemas/CmsHccV22'
cmsHccVx:
type: array
xml:
name: cms-hcc-vx
items:
$ref: '#/components/schemas/CmsHccVx'
cmsHccV12:
type: array
xml:
name: cms-hcc-v12
items:
$ref: '#/components/schemas/CmsHccV12'
cmsHccEsrdPace:
type: array
xml:
name: cms-hcc-esrd-pace
items:
$ref: '#/components/schemas/CmsHccEsrdPace'
rxHccV04:
type: array
xml:
name: rx-hcc-v04
items:
$ref: '#/components/schemas/RxHccV04'
rxHcc:
type: array
xml:
name: rx-hcc
items:
$ref: '#/components/schemas/RxHcc'
xml:
name: hcc
CategoryNotes:
required:
- subSection
type: object
properties:
subSection:
type: array
xml:
name: sub-section
items:
$ref: '#/components/schemas/SubSection'
ChapterNotes:
required:
- categoryNotes
- subSection
type: object
properties:
subSection:
type: array
xml:
name: sub-section
items:
$ref: '#/components/schemas/SubSection'
categoryNotes:
$ref: '#/components/schemas/CategoryNotes'
CodeNotes:
required:
- categoryNotes
- subSection
type: object
properties:
subSection:
type: array
xml:
name: sub-section
items:
$ref: '#/components/schemas/SubSection'
categoryNotes:
$ref: '#/components/schemas/CategoryNotes'
CodeRangeNotes:
required:
- categoryNotes
- subSection
type: object
properties:
subSection:
type: array
xml:
name: sub-section
items:
$ref: '#/components/schemas/SubSection'
categoryNotes:
$ref: '#/components/schemas/CategoryNotes'
Icd10CmInstructionalNotes:
required:
- categoryNotes
- chapterNotes
- codeNotes
- codeRangeNotes
- sectionNotes
type: object
properties:
sectionNotes:
$ref: '#/components/schemas/SectionNotes'
chapterNotes:
$ref: '#/components/schemas/ChapterNotes'
categoryNotes:
$ref: '#/components/schemas/CategoryNotes'
codeRangeNotes:
$ref: '#/components/schemas/CodeRangeNotes'
codeNotes:
$ref: '#/components/schemas/CodeNotes'
xml:
name: icd10-cm-instructional-notes
SectionNotes:
required:
- categoryNotes
- subSection
type: object
properties:
subSection:
type: array
xml:
name: sub-section
items:
$ref: '#/components/schemas/SubSection'
categoryNotes:
$ref: '#/components/schemas/CategoryNotes'
SubSection:
type: object
properties:
header:
type: string
note:
type: array
items:
type: string
InstructionalNote:
required:
- note
type: object
properties:
header:
type: string
note:
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
Icd10Code:
required:
- code
type: object
properties:
code:
type: string
desc:
type: string
tips:
type: string
premierPick:
type: string
xml:
name: premier-pick
billTogether:
type: string
xml:
name: bill-together
href:
type: string
xml:
attribute: true
Icd10Mapping:
type: object
properties:
node:
type: array
items:
$ref: '#/components/schemas/Icd10Code'
xml:
name: icd-10-mapping
Icd9Code:
required:
- code
type: object
properties:
code:
type: string
desc:
type: string
tips:
type: string
premierPick:
type: string
xml:
name: premier-pick
billTogether:
type: string
xml:
name: bill-together
href:
type: string
xml:
attribute: true
Icd9Mapping:
type: object
properties:
node:
type: array
items:
$ref: '#/components/schemas/Icd9Code'
xml:
name: icd-9-mapping
Contractors:
type: object
properties:
type:
$ref: '#/components/schemas/Links'
fi:
$ref: '#/components/schemas/Links'
ca:
$ref: '#/components/schemas/Links'
na:
$ref: '#/components/schemas/Links'
nb:
$ref: '#/components/schemas/Links'
xml:
name: Contractors
Links:
type: object
properties:
link:
type: array
xml:
name: Link
items:
$ref: '#/components/schemas/Link'
Code:
type: object
properties:
policy:
type: array
items:
$ref: '#/components/schemas/Policy'
value:
type: string
xml:
attribute: true
Policies:
type: object
properties:
code:
type: array
items:
$ref: '#/components/schemas/Code'
link:
type: array
items:
$ref: '#/components/schemas/Link'
xml:
name: policies
Ama:
type: object
properties:
code:
type: string
description:
type: string
Modifier51Exempt:
required:
- ama
- optum360
type: object
properties:
optum360:
type: array
items:
$ref: '#/components/schemas/Optum360'
ama:
type: array
items:
$ref: '#/components/schemas/Ama'
xml:
name: modifier-51-exempt
Optum360:
type: object
properties:
code:
type: string
description:
type: string
ModifierProperty:
required:
- sources
type: object
properties:
description:
type: string
definition:
type: string
usage:
type: string
sources:
$ref: '#/components/schemas/Sources'
physician:
$ref: '#/components/schemas/Links'
facility:
$ref: '#/components/schemas/Links'
opps:
$ref: '#/components/schemas/Links'
asc:
$ref: '#/components/schemas/Links'
ambulance:
$ref: '#/components/schemas/Links'
dme:
$ref: '#/components/schemas/Links'
mpfs:
$ref: '#/components/schemas/Links'
xml:
name: modifier-property
Source:
type: object
properties:
value:
type: string
type:
type: string
xml:
attribute: true
SourceRationale:
type: object
properties:
value:
type: string
type:
type: string
xml:
attribute: true
Sources:
required:
- source
- sourceRationale
type: object
properties:
source:
type: array
items:
$ref: '#/components/schemas/Source'
sourceRationale:
type: array
xml:
name: source_rationale
items:
$ref: '#/components/schemas/SourceRationale'
ModifierDesc:
type: object
properties:
descFull:
type: string
xml:
name: desc-full
usage:
type: string
definition:
type: string
xml:
name: code-properties
Modifiers:
type: object
properties:
physician:
$ref: '#/components/schemas/Links'
facility:
$ref: '#/components/schemas/Links'
opps:
$ref: '#/components/schemas/Links'
mpfs:
$ref: '#/components/schemas/Links'
asc:
$ref: '#/components/schemas/Links'
ambulance:
$ref: '#/components/schemas/Links'
dme:
$ref: '#/components/schemas/Links'
xml:
name: modifiers
Fee:
required:
- global
type: object
properties:
global:
type: string
prof:
type: string
tc:
type: string
Mpfs:
required:
- mpfsFee
type: object
properties:
mpfsFee:
$ref: '#/components/schemas/Fee'
mpfsRvu:
$ref: '#/components/schemas/Rvu'
xml:
name: mpfs
Rvu:
required:
- global
type: object
properties:
global:
$ref: '#/components/schemas/RvuType'
prof:
$ref: '#/components/schemas/RvuType'
tc:
$ref: '#/components/schemas/RvuType'
RvuType:
type: object
properties:
totalRvu:
type: string
xml:
name: total-rvu
workRvu:
type: string
xml:
name: work-rvu
peRvu:
type: string
xml:
name: pe-rvu
mpRvu:
type: string
xml:
name: mp-rvu
GlobalInfo:
required:
- global
- intraoperative
- postoperative
- preoperative
type: object
properties:
preoperative:
type: string
xml:
name: Preoperative
intraoperative:
type: string
xml:
name: Intraoperative
postoperative:
type: string
xml:
name: Postoperative
global:
type: string
xml:
name: Global
xml:
name: global-info
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
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
Conflict:
type: object
properties:
code1:
$ref: '#/components/schemas/Code1'
code2:
$ref: '#/components/schemas/Code2'
name:
type: string
message:
type: string
Multicci:
required:
- conflict
type: object
properties:
conflict:
type: array
items:
$ref: '#/components/schemas/Conflict'
xml:
name: multicci
ExcludesNotes:
required:
- note
type: object
properties:
excludesHeader:
type: string
xml:
name: excludes-header
note:
type: array
items:
$ref: '#/components/schemas/Note'
ExcludesNotes1:
required:
- note
type: object
properties:
excludesHeader1:
type: string
xml:
name: excludes-header-1
note:
type: array
items:
$ref: '#/components/schemas/Note'
ExcludesNotes2:
required:
- note
type: object
properties:
excludesHeader2:
type: string
xml:
name: excludes-header-2
note:
type: array
items:
$ref: '#/components/schemas/Note'
IncludesExcludesNotes:
type: object
properties:
includesNotes:
$ref: '#/components/schemas/IncludesNotes'
excludesNotes:
$ref: '#/components/schemas/ExcludesNotes'
excludesNotes1:
$ref: '#/components/schemas/ExcludesNotes1'
excludesNotes2:
$ref: '#/components/schemas/ExcludesNotes2'
xml:
name: includes-excludes-notes
IncludesNotes:
required:
- note
type: object
properties:
includesHeader:
type: string
xml:
name: includes-header
note:
type: array
items:
$ref: '#/components/schemas/Note'
Note:
type: object
properties:
content:
type: string
indentation:
type: integer
format: int32
xml:
attribute: true
OPPSCrossCode:
required:
- code
- description
- effectiveDate
- referenceCrossCode
type: object
properties:
code:
type: string
description:
type: string
referenceCrossCode:
type: string
xml:
name: reference-cross-code
effectiveDate:
type: string
xml:
name: effective-date
xml:
name: opps-cross-code
OPPSCrossCodeList:
type: object
properties:
oppsCrossCodes:
type: array
xml:
name: opps-cross-code
items:
$ref: '#/components/schemas/OPPSCrossCode'
xml:
name: opps-cross-code-list
OptumSpecialtyArticle:
required:
- articleText
- articleTitle
- code
- date
- issue
- source
- year
type: object
properties:
code:
type: string
year:
type: string
issue:
type: string
source:
type: string
articleTitle:
type: string
xml:
name: article-title
date:
type: string
articleText:
type: string
xml:
name: article-text
abstract:
type: string
OptumSpecialtyArticles:
type: object
properties:
optumSpecialtyArticle:
type: array
items:
$ref: '#/components/schemas/OptumSpecialtyArticle'
xml:
name: optumSpecialtyArticles
PhysicianDoc:
required:
- text
type: object
properties:
title:
type: string
text:
type: string
PhysicianDocs:
type: object
properties:
physicianDoc:
type: array
xml:
name: physician-doc
items:
$ref: '#/components/schemas/PhysicianDoc'
xml:
name: physician-docs
RevCodeDesc:
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
xml:
name: code-properties
Item:
type: object
properties:
code:
type: string
desc:
type: string
tobFacilityCode:
type: string
xml:
name: tob-facility-code
tobFacilityCodeDesc:
type: string
xml:
name: tob-facility-code-desc
note:
type: string
codetype:
type: string
xml:
attribute: true
ProcedureCodesToRevenue:
type: object
properties:
item:
type: array
items:
$ref: '#/components/schemas/Item'
xml:
name: procedure-codes-to-revenue
RevenueCodeToProcedure:
type: object
properties:
item:
type: array
items:
$ref: '#/components/schemas/Item'
link:
type: array
items:
$ref: '#/components/schemas/Link'
xml:
name: revenue-code-to-procedure
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