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openapi: 3.2.0
info:
title: Optum Real-Time eContent Web services Code Information API
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 CodeLogic™ 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: []
tags:
- name: Code Information
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<UL><LI>facility-cci</LI><LI>non-facility-cci</LI></UL>
required: true
schema:
type: string
enum:
- facility-cci
- non-facility-cci
- name: data
in: query
description: 'Comma seperated list of<UL><LI>reason : e.g. Anesthesia Included in Surgical Procedure</LI><LI>modifier-allowed : e.g. true</LI><LI>modifier-allowed : e.g. true</LI></UL>'
schema:
type: string
example: reason,modifier-allowed
- name: types
in: query
description: 'Comma seperated list of<UL><LI>cci-column2 : procedures that are included</LI><LI>cci-column1 : procedures in which this is included</LI><LI>cci-all : All of the above 2 types </LI></UL>'
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}/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: <P><FONT color=blue>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.</FONT><FONT color=red><STRIKE>EST OUTPT L3 EXP PROB H&E LOW COMPLX MED DEC</STRIKE></FONT>
char48Info: <P><FONT color=blue>OFFICE</FONT><FONT color=red><STRIKE>OFC</STRIKE></FONT>/<FONT color=blue>OUTPATIENT ESTABLISHED LOW</FONT><FONT color=red><STRIKE>OUTPT VISIT E&M EST</STRIKE></FONT> <FONT color=blue>MDM 20</FONT>-<FONT color=blue>29</FONT><FONT color=red><STRIKE>MOD SEVERITY 15</STRIKE></FONT> MIN
char35Info: <P><FONT color=blue>OFFICE O</FONT><FONT color=red><STRIKE>OFC</STRIKE></FONT>/<FONT color=blue>P EST LOW</FONT><FONT color=red><STRIKE>OUTPT E&M ESTAB</STRIKE></FONT> <FONT color=blue>20</FONT>-<FONT color=blue>29</FONT><FONT color=red><STRIKE>MOD 15</STRIKE></FONT> 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<UL><LI>desc-35 : up to 35 character description (except 3rd or 4th digit ICD-10-PCS)</LI><LI>desc-48 : up to 48 character description (except 3rd or 4th digit ICD-10-PCS)</LI><LI>desc-255 : up to 255 character description (except 3rd or 4th digit ICD-10-PCS)</LI><LI>desc-full : full description </LI><LI>desc-lay : Lay description (only for cpt/hcpcs/icd9v1/icd10cm)</LI><LI>coding-tip</LI><LI>documentation-tip</LI><LI>reimbursement-tip</LI></UL>'
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/{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/{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:
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: <b>Reduction</b>
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
/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}/{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
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# Full source: https://raw.githubusercontent.com/api-evangelist/optum/refs/heads/main/openapi/optum-code-information-api-openapi.yml