Optum MCE Edits ICD9 and ICD10 API

openapi: 3.2.0
info:
  title: CMS Common Facility MCE Edits ICD9 and ICD10 API
  description: MicroService that contains CMS related information
  contact:
    name: Ken Kracker
    email: ken.kracker@optum.com
  version: v1.0
servers:
- url: /v1/cmscommonms
tags:
- name: MCE Edits ICD9 and ICD10 API
paths:
  /api/cms/facility/{codetype}/mce-edits:
    get:
      tags:
      - MCE Edits ICD9 and ICD10 API
      summary: Fetches MCE Edits data
      operationId: fetchMCEEdits
      parameters:
      - name: codetype
        in: path
        required: true
        schema:
          type: string
          enum:
          - icd9
          - icd10
      - name: sort
        in: query
        description: Any of these (code,-code) are allowed values, default is -code
        required: false
        schema:
          type: array
          items:
            type: string
          default:
          - code
      - name: limit
        in: query
        required: false
        schema:
          type: integer
          format: int32
          default: 50
        example: 150
      - name: page
        in: query
        required: false
        schema:
          type: integer
          format: int32
          default: 1
      - name: filter
        in: query
        required: false
        schema:
          type: string
      - 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 MCE edits data
          content:
            application/json:
              example:
                content:
                - code: '3'
                  description: DUPLICATE OF PRINCIPAL DIAGNOSIS
                  definition: Any secondary diagnosis that is the same code as the principal diagnosis is identified as a duplicate because the secondary code may cause an erroneous assignment to an MS-DRG with complications.  The contractor will delete the duplicate secondary diagnosis and process the bill.
                - code: '4'
                  description: AGE CONFLICT
                  definition: This edit identifies inconsistencies between a patient's age and any diagnosis on the patient's record.  The diagnosis is considered clinically impossible for a patient in the stated age.  Either the diagnosis or the age is considered inaccurate.  The contractor will return the claim for correction of this error.
                  associatedCodeLink:
                    value: '4'
                    href: /api/cms/facility/mce/associated-icd9/4
                totalCount: 19
        '400':
          description: Bad request
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Notification'
              example:
                error:
                - sort parameter value should be from list of [code]
                warning: null
                info: null
        '404':
          description: Not found
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Notification'
              example:
                timestamp: '2024-04-12T13:52:54.478+00:00'
                status: 404
                error: Not Found
                trace: 'org.springframework.web.servlet.resource.NoResourceFoundException: No static resource api/cms/facility/mce-edits.'
        '500':
          description: Internal server error
          content:
            application/json:
              example:
                timestamp: '2024-04-12T13:38:46.141+00:00'
                status: 500
                error: Internal Server Error
                path: cmscommonms/api/cms/facility/icd10/mce-edits?limit=50&page=1
                message: 'java.lang.IllegalArgumentException: Page size must not be less than one'
      security:
      - bearerAuth: []
  /api/cms/facility/icd9/{code}/mce-edits:
    get:
      tags:
      - MCE Edits ICD9 and ICD10 API
      summary: Fetches MCE code edits for icd9 codes
      operationId: getMCEEditsICD9
      parameters:
      - name: code
        in: path
        required: true
        schema:
          type: string
      - 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 MCE specific edit ICD9 codes
          content:
            application/json:
              example:
              - header: This edit detects an OR procedure code
                description: Valid operating room procedure - A procedure that triggers a change in DRG assignment.
              - header: This is a postpayment edit that detects a bilateral procedure.
                description: Bilateral Edit - Due to the lack of laterality in ICD-9-CM there are certain lower extremity joint procedure codes that do not accurately reflect procedures that are performed in one admission on two or more different bilateral joints. This edit identifies procedure codes that when coded twice, represent the same procedure performed on both of the same bilateral joints of the lower extremity.  Otherwise, a code edit will instruct the fiscal intermediary to verify that the two different procedures were performed on two different bilateral joints.  (MCE Edit 14).
        '404':
          description: Not found
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Notification'
              example:
                timestamp: '2023-07-14T06:37:03.741+00:00'
                status: 404
                error: Not Found
                message: Not Found
                path: /cmscommonms/api/cms/facility/icd91/81.51/mce-edits
        '500':
          description: Internal server error
          content:
            application/json:
              example:
                timestamp: '2023-07-13T06:36:22.518+00:00'
                path: /cmscommonms/api/cms/facility/icd9/81.51/mce-edits
                status: 500
                error: Internal Server Error
                requestId: e36d239e-324
      security:
      - bearerAuth: []
  /api/cms/facility/icd10/{icd10Code}/mce-edits:
    get:
      tags:
      - MCE Edits ICD9 and ICD10 API
      summary: Fetches MCE Edits data based on icd10code
      operationId: fetchMCEEditsICD10
      parameters:
      - name: icd10Code
        in: path
        required: true
        schema:
          type: string
      - name: limit
        in: query
        required: false
        schema:
          type: integer
          format: int32
          default: 50
        example: 150
      - name: page
        in: query
        required: false
        schema:
          type: integer
          format: int32
          default: 1
      - 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 MCE Edits Data based on icd10code
          content:
            application/json:
              example:
                content:
                - code: '3'
                  description: DUPLICATE OF PRINCIPAL DIAGNOSIS
                  definition: Any secondary diagnosis that is the same code as the principal diagnosis is identified as a duplicate because the secondary code may cause an erroneous assignment to an MS-DRG with complications.  The contractor will delete the duplicate secondary diagnosis and process the bill.
                - code: '4'
                  description: AGE CONFLICT
                  definition: This edit identifies inconsistencies between a patient's age and any diagnosis on the patient's record.  The diagnosis is considered clinically impossible for a patient in the stated age.  Either the diagnosis or the age is considered inaccurate.  The contractor will return the claim for correction of this error.
                  associatedCodeLink:
                    value: '4'
                    href: /api/cms/facility/mce/associated-icd9/4
                totalCount: 19
        '404':
          description: Not found
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/Notification'
              example:
                timestamp: '2024-04-12T13:52:54.478+00:00'
                status: 404
                error: Not Found
                path: /cmscommonms/api/cms/facility/icd1/02BK0ZZ/mce-edits
        '500':
          description: Internal server error
          content:
            application/json:
              example:
                timestamp: '2024-04-12T13:38:46.141+00:00'
                status: 500
                error: Internal Server Error
                path: cmscommonms/api/cms/facility/icd10/02BK0ZZ/mce-edits?limit=0&page=1
                message: 'java.lang.IllegalArgumentException: Page size must not be less than one'
      security:
      - bearerAuth: []
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-readme:
  explorer-enabled: true
  proxy-enabled: true