CCI / MUE API Response Codes
CCI / MUE response codes contain an array of objects called items.
The properties in each include:
Code |
String |
Procedure code |
modifiers |
CciModifierItem[] |
Array of details for each modifier passed in with this code. Properties include:
Property |
Data type |
Description |
modCode |
string |
The modifier code |
status |
string |
Status associated with modifier. Possible values include:
|
message |
string |
Message for modifier, usually associated with status. |
|
codeId |
int |
VitalWare internal code identifier |
status |
string |
Status value returned for validation of procedure code Values include:
|
issues |
CciIssue[] |
Array of issues encountered validating code. Properties for each issue include:
- 1 - OK
- 2 - Warning
- 3 - Error
- 4 - An issue that was resolved by usage of a compatible modifier
Property |
Data type |
Description |
status |
int |
Numeric representation of status value. Note that this will be normalized to the other values for status used elsewhere in a future version. Possible values include: |
message |
string |
Message associated with issue |
|
shortDescription |
string |
Short code description |
longDescription |
string |
Long code description |
codeType |
string |
Type of code |
isValid |
bool |
Whether or not the code was found and is valid |
invalidReason |
string |
Reason code was not valid. Valid values include:
- "NotFound"
- "Deleted"
- "Invalid"
|
statusIndicator |
string |
Status indicator associated with code |
statusIndicatorDescription |
string |
Description for status indicator |
statusIndicatorExplanation |
string |
Additional information for status indicator |
workRvu |
decimal |
Work RVU |
mpRvu |
decimal |
MP RVU |
tranFacPeRvu |
decimal |
Facility PE RVU |
tranNonFacPeRvu |
decimal |
Non Facility PE RVU |
fullImpFacTotal |
decimal |
Total Facility RVU |
fullImpNonFacTotal |
decimal |
Total Non Facility RVU |
mueValue |
int |
MUE Value |
mueAdjudicationIndicator |
string |
MUE adjudication indicator with description |
CodeValidate API Response
After processing the request, the service returns results in a generic wrapper which contains the number of items (count) and the result payload (result). The contents of the result payload are as follows:
Property |
Data type |
Description |
codes |
Dictionary <string,CodeDetail> |
A dictionary keyed by code, containing code details for all procedure and diagnoses codes passed in.
CodeDetail properties include:
Property |
Data type |
Description |
shortDescription |
string |
Short code description |
longDescription |
string |
Long code description |
codeType |
string |
Type of code |
isValid |
bool |
Whether or not the code was found and is valid |
invalidReason |
string |
Reason code was not valid. Valid values include:
- "NotFound"
- "Deleted"
- "Invalid"
|
statusIndicator |
string |
Status indicator associated with code |
|
policies |
Dictionary <string,PolicySummary> |
A dictionary keyed by policy label, containing information for all sources referenced. The PolicySummary properties include:
Property |
Data type |
Description |
policyType |
string |
Source type. Values include:
- "L" - LCD
- "A" - Article
- "N" - NCD
- "C" - CMS Manual
- "T" - Transmittal
- "M" - MLN Matter Article
|
title |
string |
Source title |
version |
int |
Source version, if applicable |
documentationRequirements |
string |
Documentation requirements that apply to source |
indications |
string |
Indications that apply to source |
limitations |
string |
Limitations that apply to source |
utilizationRequirements |
string |
Utilization requirements that apply to source |
publication |
string |
Publication number, if applicable |
isInLibrary |
bool |
Whether or not source is in VW library |
|
items |
ResultItem[] |
Validation results for each of the passed in CPT/HCPCS codes, see below for more information about properties within a ResultItem. |
ResultItem, ResultSubItem
- ResultItem and ResultSubItem objects are identically defined except that a ResultItem contains one or more ResultSubItem objects within it.
- ResultItem objects contain validation results for each CPT/HCPCS code, while ResultSubItem objects contain validation for a diagnosis in relation to the CPT/HCPCS code it is contained within.
- You should expect to see exactly one ResultItem per CPT/HCPCS code passed in, and within each one, exactly one ResultSubItem per diagnosis code. This is true regardless if the code is valid or invalid.
subItems |
ResultSubItem[] |
Validation results for each diagnosis code in combination with the CPT/HCPCS code for the ResultItem. NOTE: This property is only present on ResultItem objects. |
code |
string |
The procedure or diagnosis code |
exceptions |
ResultItemException[] |
Exceptions for this code, such as age, gender or frequency. Properties within each include:
Property |
Data type |
Description |
policy |
string |
Source for exception |
exception |
string |
Type of exception. Possible values include:
- "Age"
- "Gender"
- "Frequency"
|
status |
string |
Status associated with exception. Values include:
|
message |
string |
Message for exception |
|
issues |
ResultItemIssue[] |
Information specific to the code or code combination. This may include message related to policy sources that are informational or may be error messages. Properties within each issue include:
Property |
Data type |
Description |
policy |
string |
Source for issue |
status |
string |
Status associated with issue. Values include:
|
message |
string |
Message for issue |
|
messages |
ResultItemMessage[] |
Informational messages specific to the code or code combination. Properties within each message include:
Property |
Data type |
Description |
policy |
string |
Source for exception |
message |
string |
Message content |
|
status |
string |
Status associated with code or code combination rolled up from issues contained within this item. Values include:
- "OK"
- "Warning"
- "Error"
- "PolicyNotFound"
- "InvalidCode"
- "DeletedCode"
|
policies |
string[] |
Policy sources that were referenced for this code combination. |