VitalWare API Developer Network

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VitalWare's web services API provide developers: 

  • Interfaces to search referential coding and regulatory content using ICD Sherpa
  • Integrate Medical Necessity validation into custom applications
ICD Sherpa Search ICD-10-CM and ICD-10-PCS codes and referential information using VitalWare's proprietary Sherpa engine.
  • Autocomplete Code Lookup and Search Suggestions
  • Sherpa Code Search and Concept Drill-down
  • ICD-10-CM and ICD-10-PCS Coding Guidelines
  • Concept Information
LCD/NCD, NCCI and MUE Validation Checks code pairs for possible Medicare medical necessity or bundling issues with easy verification of NCD, LCD and NCCI edits.
  • CodeValidate API
  • Populate your own validation engine with edits available via API calls or data files
  • Policy and Article PDFs
  • Medically Unlikely Edits (MUE)
CPT®/HCPCS and Referential Info

Search procedure codes and associated referential information:

CPT

  • Autocomplete Code Search
  • Code Detail*
  • CPT Guidelines*
  • Medically Unlikely Edits (MUE)
  • Modifiers
  • Modifier Guidelines
  • Medicare Physician Fee Schedule (MPFS)
  • Revenue Codes**
  • Ambulatory Payment Classifications (APC)
  • Ambulatory Surgery Center (ASC)
  • Add-on Codes
  • CPT Medicare Crosswalk
  • Standard Analytics File (SAF)

 

HCPCS

  • Autocomplete Code Search
  • Code Detail
  • Medically Unlikely Edits (MUE)
  • Modifiers
  • Modifier Guidelines
  • Medicare Physician Fee Schedule (MPFS)
  • Revenue Codes
  • Add-on Codes

 

* Requires a license agreement with the American Medical Association (AMA)
** Requires a license agreement with the American Hospital Association (AHA)

ICD-10 Codes and Referential Info Search ICD-10 Codes and associated referential information:

ICD-10-CM

  • Autocomplete Code Search
  • Code Detail
  • Coding Guidelines
  • Tabular List of Diseases and Injuries
  • Alphabetic Index of Diseases and Injuries
  • Neoplasm Table
  • Table of Drugs and Chemicals
  • The Alphabetic Index to External Causes

ICD-10-PCS

  • Autocomplete Code Search
  • Code Detail
  • Coding Guidelines
  • PCS Tables
  • Alphabetic Index

 

Code Mappings, Crosswalks

 

  • GEMS Forward and Reverse Mapping
  • SNOMED CT Concepts to ICD-10-CM codes
  • CPT to HCPCS Crosswalk

 

Grouping Group and price encounters for:
  • MS-DRG
  • APR-DRG
  • APC
Fee Schedules & Calculators
  • Relative Value Units (RVUs)
  • Ambulance Fee Schedule
  • Durable Medical Equipment (DME) Fee Schedule
  • Medicare Physician Fee Schedule (MPFS)
  • Outpatient PPS (OPPS) Calculator
  • Clinical Lab Fee Schedule
SNOMED Search Search SNOMED CT concepts, relationships and corresponding information:
  • Concepts
  • SNOMED CT Relationships
  • I-MAGIC (Interactive Map-Assisted Generation of ICD Codes) SNOMED CT to ICD-10-CM map

VitalWare provides HTML controls for referential coding functionality that has built-in navigation and logic for easy deployment to your end users, customized to match your system's look and feel.

iDocuMint

Embed iDocuMint, VitalWare's UI for the Sherpa engine, into your application. Available as an embedded HTML iFrame or as a Microsoft .Net DLL (dynamic link library).

VitalWare's iDocuMint

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VitalKnowledge

Embed the full VitalKnowledge UI into your application, including code lookup and coding referential information.

VitalWare's VitalKnowledge™

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Code Referential Information

Embed VitalKnowledge code referential information into your application to view referential information on a single code for the following code sets:

  • APC
  • CPT®/HCPCS
  • ICD-9-CM
  • ICD-10-CM
  • ICD-10-PCS
  • Modifiers
  • MS-DRG
  • NDC/Pharmacy
  • Revenue Codes
  • Devices
VitalWare's VitalKnowledge™ - South Panel

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CodeValidate

Embed Medical Necessity validation for NCCI and LCD/NCD edits into your application.

VitalWare's CodeValidate Module

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VitalWare provides access to raw data files on a scheduled basis. Files are natively delivered in JSON or XML or can be customized to your specifications:

LCD, NCD, NCCI and MUE Edits
  • LCD Edits
  • NCD Edits
  • Policy and Article PDFs
  • NCCI Edits
  • Medically Unlikely Edits (MUE)
CPT®/HCPCS Codes and Referential Info

Procedure codes and referential information linked to these codes. Codes in the files can be linked either by CodeID or Code + CodeType.

CPT

  • Code Detail*
  • CPT Guidelines*
  • Medically Unlikely Edits (MUE)
  • Modifiers
  • Modifier Guidelines
  • Medicare Physician Fee Schedule (MPFS)
  • Revenue Codes**
  • Ambulatory Payment Classifications (APC)
  • Ambulatory Surgery Center (ASC)
  • Add-on Codes
  • CPT Medicare Crosswalk
  • Standard Analytics File (SAF)

 

HCPCS

  • Code Detail
  • Medically Unlikely Edits (MUE)
  • Modifiers
  • Modifier Guidelines
  • Medicare Physician Fee Schedule (MPFS)
  • Revenue Codes
  • Add-on Codes

 

* Requires a license agreement with the American Medical Association (AMA)
** Requires a license agreement with the American Hospital Association (AHA)

ICD-10 Codes and Referential Information

ICD-10-CM

  • Code Detail
  • Coding Guidelines
  • Tabular List of Diseases and Injuries
  • Alphabetic Index of Diseases and Injuries
  • Neoplasm Table
  • Table of Drugs and Chemicals
  • The Alphabetic Index to External Causes

ICD-10-PCS

  • Code Detail
  • Coding Guidelines
  • PCS Tables
  • Alphabetic Index

 

Code Mappings and Crosswalks

 

  • GEMS Forward and Reverse Mapping
  • Sherpa Primary Lookup ICD-9 to ICD-10 concept-based mappings
  • SNOMED CT Concepts to ICD-10-CM codes
  • CPT to HCPCS Crosswalk

 

Fee Schedules
  • Relative Value Units (RVU)
  • Ambulance Fee Schedule
  • Durable Medical Equipment (DME) Fee Schedule
  • Medicare Physician Fee Schedule (MPFS)