Vitalware API Developer Portal

Register Documentation Interactive API Support

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
  • ICD Sherpa API for 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 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 Information

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 Information 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 and Crosswalks
  • GEMS Forward and Reverse Mapping
  • CPT to HCPCS Crosswalk
  • CPT to ICD-10-PCS
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

VitalWare  provides access to raw data files on a scheduled cycle. Files are delivered in JSON and 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 Information

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)