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CPT Vignettes API Implementation Guide

The CPT® Vignettes API Implementation Guide provides a framework for integrating over 5,565 vignettes that offer detailed insights into specific CPT codes, including pre-service, intra-service, and post-service descriptions. It outlines implementation steps, required API calls, and examples of CURL commands and API responses. The API is intended for healthcare organizations to validate and utilize CPT codes effectively in their operations.

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24 views

CPT Vignettes API Implementation Guide

The CPT® Vignettes API Implementation Guide provides a framework for integrating over 5,565 vignettes that offer detailed insights into specific CPT codes, including pre-service, intra-service, and post-service descriptions. It outlines implementation steps, required API calls, and examples of CURL commands and API responses. The API is intended for healthcare organizations to validate and utilize CPT codes effectively in their operations.

Uploaded by

hassank8520
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CPT® Vignettes API

Implementation Guide

Page 1 of 4
Contents
1. CPT® VIGNETTES API IMPLEMENTATION GUIDE.............................................................................................................2
2. WHAT IS THE CPT VIGNETTES API?........................................................................................................................................2
3. IMPLEMENTATION STEPS..........................................................................................................................................................3
4. EXAMPLE: CURL COMMAND.....................................................................................................................................................3
5. EXAMPLE: API RESPONSE..........................................................................................................................................................3
6. EXAMPLE API USE CASE.............................................................................................................................................................4

1. CPT® Vignettes API Implementation Guide

This guide is meant to help your organization implement the CPT® Vignettes content by using the Application
Programming Interfaces (APIs).

2. What is the CPT Vignettes API?

CPT Vignettes is the foundation for this API. This API includes over 5565 vignettes, of which, 80% have pre-
service descriptions provided, 97% have intra-service descriptions provided, 80% have post-service
descriptions provided. These are designed to provide detailed insights into a specific CPT code as vignettes
are a 1:1 match on a CPT code.

CPT Vignettes content is intended for healthcare organizations such as encoders and distributors, that
currently incorporate CPT codes for either internal use or distribution of products to end users. Vignettes are
an important validation tool when selecting the correct CPT code. This describes the typical patient and work
provided by the physician/practitioner.

The content currently included in this API includes:

 Complete view of a CPT Code:


Field Description
CPT Code CPT Code Number
Typical Patient Description of the vignette of the typical patient who would receive the
procedure/service including diagnosis and relevant conditions
Pre-Service Includes physician work provided before the onset of the procedure
Intra-Service For most non-surgical face-to-face services, the intra-service period includes the
services provided while the physician is with the patient or “skin-to-skin”. For
invasive surgical procedures, the intra-service period includes all “skin-to-skin”
work that is a necessary part of the procedure. Skin-to-skin work means cut to
closure. For endoscopic procedures, the intra-service period includes all “scope
in-to-scope out” work that is a necessary part of the procedure. For imaging and
diagnostic services, the intra-service period begins at the onset of the
examination and ends after the examination is interpreted.
Post-Service For services without a global period, the post-service includes services provided
on the day of the procedure after the procedure has been performed. For surgical
procedures, the post-service period may include post-operative care in the OR
beginning after the wounds are closed or the endoscope is removed. Post-
operative work may also include stabilizing the patient, communicating with the
patient and other professionals, and any subsequent E/M visits. For surgical
procedures with a 0-day global period, the post-service period ends at midnight
on the day of the procedure. For surgical procedures with either a 10-day or 90-
day global period, the post-service period includes all inherent services and E/M
visits provided on the day of the procedure and within either 10 or 90 days after
the procedure, respectively.

3. Implementation steps
The AMA Intelligent Platform provides a walkthrough of steps required to use the developer portal HERE.
Swagger resource specifications are available in the ‘Try Out’ section of the API Overview. The CPT Vignette’s
Readme is included in the files.

Specific API Calls

1. *Required Header Fields*


a. System-ID
b. Organization-ID
c. User-ID
2. GET /vignette: https://api-platform.ama-assn.org/vignettes/1.0.0/vignettes/{cptcode}
a. CPT Code Search
b. Returns a complete view of the searched CPT code vignette which includes the data
fields above
3. GET/Additional_Information:
https://api-platform.ama-assn.org/vignettes/1.0.0/vignettes/{cptCode}?
additional_information=true
a. Additional information includes Reviewed Date by the RUC committee and Concept ID

4. Example: CURL command


curl -X GET "https://api-platform.ama-assn.org/vignettes/1.0.0/vignettes/11042" -H "accept: application/json" -H "x-
system-id: Test123" -H "x-organization-id: Testing Organization" -H "x-user-id: Testing User ID" -H "Authorization: Bearer
Toekn”

5. Example: API Response


{
"cpt_code": "11042",

"typical_patient": "A 66-year-old male with insulin dependent diabetes presents with a 4.0 cm x 3.5 cm x 0.8 cm non-
infected ulceration involving the skin and subcutaneous tissue of the plantar lateral aspect of the right heel. The decision
is made to debride the wound.",

"pre_service_info": "Review labs and/or imaging studies, if available. Meet with patient/family to review the benefits, risks
and alternatives to debridement. An updated medication history is obtained, including aspirin, vitamin E, and/or other
blood thinners along with a review of pertinent medical problems that may have arisen since the previous visit. The
planned procedure is explained and the healing period with restrictions is reviewed. Review and have patient sign
informed consent. Assist with patient positioning in a supine and slightly lateral position, with the leg bumped up 30
degrees and stabilized. The existing dressings are removed. An appropriate physical examination is performed to include
the vascular and neurological status of the lower extremity(-ies). The wound and surrounding skin is prepped and draped.
Perform surgical \"time out\" with operating surgical team.",

"intra_service_info": "Inspect and document the ulceration for size, location, depth; classification/staging; and any
interval changes, if appropriate, from any previous inspections. Anesthesia, if necessary, is utilized. The ulcer bed is
debrided with forceps, scalpel, scissors or tissue nippers excising the necrotic skin, if present, and subcutaneous tissues
to the level of viable tissue. The wound is irrigated and hemostasis is obtained. Upon completion, the ulcer is re-measured
and the size recorded.",

"post_service_info": "Apply an appropriate surgical dressing based upon the amount of exudate present at the time of
debridement. Provide for a moist healing environment to help assist with subsequent wound healing and granulation
tissue formation. Determine type of padding and specific material needed to offload the ulcer area; cut pad to properly
remove pressure; apply padding. Instruct patient and/or care giver on appropriate home care; discuss future management
of the condition; instruct on proper selection and sizing of footwear; instruct on importance of controlling concomitant
medical conditions; dictate operative report; complete medical record; communicate with primary care physician. Arrange
follow-up care."
}

6. Example API use case


The API resources are not designed specifically for the following use case; this example simply provides a way
to understand how licensees might use this API in their situation.

Use Case: Vendor wants to automate the retrieval of yearly and past released Vignettes to reduce risk manual
ingestion into central data systems that feed end-user products.

*All content is run through the UTF-8 and ASCII character sets. Please review as special characters could have been missed.

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