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API Reference

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:
  • "OK"
  • "Warning"
  • "Error"
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:
  • "OK"
  • "Warning"
  • "Error"
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:
  • "OK"
  • "Warning"
  • "Error"
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:
  • "OK"
  • "Warning"
  • "Error"
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.

version 9 as of 5 years ago by Unknown