Optum

Optum Code Specific Guidelines APIs API

The Code Specific Guidelines APIs API from Optum — 2 operation(s) for code specific guidelines apis.

GitHub OpenAPI
Business capability
Medical Coding Management BC-2870.20

Operations 2

GET /api/optum/common/code-specific-guidelines/{codetype}/article/{code}/{article-id} Fetch current year code specific guidelines article #
GET /api/optum/common/code-specific-guidelines/{codetype}/article-list/{code} Fetch current year code specific guidelines articles list #

Documentation

📖
APIReference
https://developer.optum.com/eligibilityandclaims/reference/api-overview
📖
GettingStarted
https://developer.optum.com/eligibilityandclaims/docs/get-started-with-optum-api
📖
Authentication
https://developer.optum.com/eligibilityandclaims/docs/optum-security-and-authorization
📖
APIReference
https://developer.optum.com/optumreal-dental/reference/overview-real-dental
📖
GettingStarted
https://developer.optum.com/optumreal-dental/reference/get-started
📖
APIReference
https://developer.optum.com/pharmacysolutions/reference
📖
APIReference
https://developer.optum.com/paymentandreimbursement/reference
📖
APIReference
https://developer.optum.com/platformandinteroperability/reference
📖
APIReference
https://developer.optum.com/analyticsandinsights/reference
📖
APIReference
https://developer.optum.com/apitools/reference/security-and-authorization-v2-overview
📖
Documentation
https://developer.optum.com/apitools/docs/getting-started

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/optum/refs/heads/main/openapi/optum-code-specific-guidelines-apis-api-openapi.yml

Other Resources

🔗
ChangeLog
https://developer.optum.com/eligibilityandclaims/docs/eligibility-release-notes

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OpenAPI Specification

optum-code-specific-guidelines-apis-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Optum Code Specific Guidelines APIs API
  version: v1.0
  contact:
    name: Ken Kracker
    email: ken.kracker@optum.com
  description: 'Operations tagged Code Specific Guidelines APIs across 2 of this provider''s published API definitions: optum-optum-common-facility-openapi.yml, optum-optum-common-physician-openapi.yml. Each path carries the servers of the definition it was published in.'
servers:
- url: /v1/optumcommonms
tags:
- name: Code Specific Guidelines APIs
paths:
  /api/optum/common/code-specific-guidelines/{codetype}/article/{code}/{article-id}:
    get:
      tags:
      - Code Specific Guidelines APIs
      summary: Fetch current year code specific guidelines article
      operationId: fetchCodeSpecificArticle
      parameters:
      - name: code
        in: path
        description: Term/code search value
        required: true
        schema:
          type: string
        example: N17.9
      - name: codetype
        in: path
        required: true
        schema:
          type: string
          enum:
          - i10_cm
          - i10_pcs
        example: i10_cm
      - name: article-id
        in: path
        required: true
        schema:
          type: string
        example: CGi10440125
      - name: yyyy-MM-dd
        in: header
        description: Date for which historical data is required
        required: false
        schema:
          type: string
          format: yyyy-MM-dd
      responses:
        '200':
          description: Fetch current year code specific guidelines article
          content:
            application/json:
              example: "{\n    \"year\": \"2025\",\n    \"title\": \"Diseases of the Genitourinary System\",\n    \"articleId\": \"CGi10440125\",\n    \"article\": \"article details\",\n    \"articleUpdate\": \"article update details\"\n    \"quarter\": 0,\n    \"sourceType\": \"CSG_CM\",\n    \"code\": \"N17.9\",\n    \"codeTypeId\": 16384\n}\n"
        '404':
          description: Not found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Notification'
              example:
                timestamp: '2025-07-11T12:23:36.422+00:00'
                status: 404
                error: Not Found
                message: Not Found
                path: /api/optum/common/code-specific-guidelines/article
        '500':
          description: Internal server error
          content:
            application/json:
              example: "{\n  \"timestamp\": \"2025-05-08T07:22:01.017+00:00\",\n  \"path\": \"/api/optum/common/code-specific-guidelines/article/N17.9\",\n  \"status\": 500,\n  \"error\": \"Internal Server Error\",\n}"
      security:
      - bearerAuth: []
    servers:
    - url: /v1/optumcommonms
  /api/optum/common/code-specific-guidelines/{codetype}/article-list/{code}:
    get:
      tags:
      - Code Specific Guidelines APIs
      summary: Fetch current year code specific guidelines articles list
      operationId: fetchCodeSpecificArticlesList
      parameters:
      - name: page
        in: query
        required: false
        schema:
          type: integer
          format: int32
          default: 1
      - name: limit
        in: query
        required: false
        schema:
          type: integer
          format: int32
          default: 50
      - name: code
        in: path
        description: Term/code search value
        required: true
        schema:
          type: string
        example: I10
      - name: codetype
        in: path
        required: true
        schema:
          type: string
          enum:
          - i10_cm
          - i10_pcs
        example: i10_cm
      - name: yyyy-MM-dd
        in: header
        description: Date for which historical data is required
        required: false
        schema:
          type: string
          format: yyyy-MM-dd
      responses:
        '200':
          description: Fetch current year code specific guidelines articles list
          content:
            application/json:
              example:
              - year: '2025'
                title: Diseases of the Genitourinary System
                articleId: CGi10440125
                quarter: 0
                sourceType: CSG_CM
                code: N17.9
                codeTypeId: 16384
        '404':
          description: Not found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Notification'
              example:
                timestamp: '2025-07-11T12:23:36.422+00:00'
                status: 404
                error: Not Found
                message: Not Found
                path: /api/optum/common/code-specific-guidelines/i10_cm/article-list
        '500':
          description: Internal server error
          content:
            application/json:
              example: "{\n  \"timestamp\": \"2025-05-08T07:22:01.017+00:00\",\n  \"path\": \"/api/optum/common/code-specific-guidelines/i10_cm/article-list/E11.01\",\n  \"status\": 500,\n  \"error\": \"Internal Server Error\",\n}"
      security:
      - bearerAuth: []
    servers:
    - url: /v1/optumcommonms
components:
  schemas:
    Notification:
      type: object
      properties:
        error:
          type: array
          items:
            type: string
        warning:
          type: array
          items:
            type: string
        info:
          type: array
          items:
            type: string
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
      bearerFormat: JWT
x-refined-from:
- optum-optum-common-facility-openapi.yml
- optum-optum-common-physician-openapi.yml
x-readme:
  explorer-enabled: true
  proxy-enabled: true