> ## Documentation Index
> Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Medicaid PTP edit — code pair

> Look up a Medicaid PTP bundling edit for a code pair (either orientation).



## OpenAPI

````yaml /docs/openapi.client.json get /v1/ncci/medicaid/ptp
openapi: 3.1.0
info:
  description: >-
    Client API for RCIntel. Authenticate with X-API-Key. See Guides → Which API
    to use.
  summary: Multi-tenant knowledge API for healthcare revenue cycle management.
  title: Healthcare Knowledge Layer
  version: 0.1.0
servers: []
security: []
tags:
  - description: >-
      Cited payer policy lookup — GET /v1/policies and GET /v1/policies/changes.
      Medicare FFS returns NCDs/LCDs/MACs; commercial payers return that payer's
      documents only. Query payer, code, state, plan_type.
    name: policies
  - description: >-
      Payer-policy PDF parse and retrieve for Workspace / Payer Knowledge.
      Service-authenticated (X-Admin-Secret); chunks stored in Postgres.
    name: policy
  - description: >-
      Manufacturer 340B contract-pharmacy policy, fail-closed access, and the
      change feed. Different API from GET /v1/policies.
    name: 340B Policy
  - description: CRD-style prior authorization check, documentation, and vendors.
    name: prior-auth
  - description: Public payer directory (no API key on list/detail).
    name: payers-public
  - description: >-
      Payer network directory — search payers, check prior auth requirements,
      view filing rules, denial patterns, and appeal levels.
    name: payers
  - description: >-
      Resolve healthcare billing knowledge across the L1-L6 layer stack.
      Includes payment calculation, billing guidance, and per-layer queries.
    name: knowledge
  - description: >-
      CMS Fee Schedule lookups — OPPS (Addendum B / APC), DMEPOS (state-level
      pricing), and Clinical Lab Fee Schedule (CLFS).
    name: fee-schedules
  - description: >-
      NCCI (National Correct Coding Initiative) — dedicated MUE limits, PTP
      bundling edits, add-on code edits, and code pair validation. Medicare
      edits under /ncci/*, the separate CMS Medicaid edit set under
      /ncci/medicaid/*.
    name: ncci
  - description: >-
      Service code intelligence — CPT/HCPCS lookup, RVU data, NCCI edits,
      payment calculation, implant/GUDID search, and service group
      classification.
    name: codes
  - description: >-
      Submit asynchronous AI agent jobs for code research, medical necessity,
      and denial resolution. Poll for results and retrieve reasoning traces.
    name: agents
  - description: >-
      Register and manage healthcare facilities by CCN (Medicare Provider
      Number). Each facility is the root entity for knowledge resolution.
    name: facilities
  - description: >-
      NPI Registry — live search against CMS NPPES API for provider and
      organization National Provider Identifiers.
    name: npi
  - description: >-
      OpenFDA drug product lookup by NDC. Includes product-level fields with
      normalized ingredient and package detail.
    name: drugs
  - name: encounter
  - name: mcp
  - description: Health checks, service metadata, and Prometheus metrics.
    name: system
paths:
  /v1/ncci/medicaid/ptp:
    get:
      tags:
        - ncci
      summary: Medicaid PTP edit — code pair
      description: >-
        Look up a Medicaid PTP bundling edit for a code pair (either
        orientation).
      operationId: get_medicaid_ptp_v1_ncci_medicaid_ptp_get
      parameters:
        - description: Column 1 (comprehensive) procedure code
          in: query
          name: col1_proc_cd
          required: true
          schema:
            description: Column 1 (comprehensive) procedure code
            title: Col1 Proc Cd
            type: string
        - description: Column 2 (component) procedure code
          in: query
          name: col2_proc_cd
          required: true
          schema:
            description: Column 2 (component) procedure code
            title: Col2 Proc Cd
            type: string
        - description: prac (practitioner), hosp (outpatient hospital), or dme
          in: query
          name: claim_type
          required: false
          schema:
            anyOf:
              - enum:
                  - prac
                  - hosp
                  - dme
                type: string
              - type: 'null'
            description: prac (practitioner), hosp (outpatient hospital), or dme
            title: Claim Type
        - description: >-
            Date of service (YYYY-MM-DD); selects the edit effective on that
            date.
          in: query
          name: date_of_service
          required: false
          schema:
            anyOf:
              - format: date
                type: string
              - type: 'null'
            description: >-
              Date of service (YYYY-MM-DD); selects the edit effective on that
              date.
            title: Date Of Service
      responses:
        '200':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/MedicaidPTPResponse'
          description: Successful Response
        '422':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
          description: Validation Error
      security:
        - APIKeyHeader: []
components:
  schemas:
    MedicaidPTPResponse:
      description: Medicaid PTP bundling edit for a code pair.
      properties:
        col1_proc_cd:
          description: Column 1 (comprehensive) code
          title: Col1 Proc Cd
          type: string
        col2_proc_cd:
          description: Column 2 (component) code
          title: Col2 Proc Cd
          type: string
        date_of_service:
          anyOf:
            - type: string
            - type: 'null'
          title: Date Of Service
        edit_delete_dt:
          anyOf:
            - type: string
            - type: 'null'
          description: Deletion date (empty if active)
          title: Edit Delete Dt
        edit_effective_dt:
          anyOf:
            - type: string
            - type: 'null'
          description: When this PTP edit took effect
          title: Edit Effective Dt
        loaded_at:
          anyOf:
            - format: date-time
              type: string
            - type: 'null'
          description: When rcintel-data curated this row
          title: Loaded At
        modifier:
          anyOf:
            - type: string
            - type: 'null'
          description: 'Modifier indicator: 0=NOT ALLOWED, 1=ALLOWED, 9=NOT APPLICABLE'
          title: Modifier
        modifier_allowed:
          anyOf:
            - type: boolean
            - type: 'null'
          description: True when modifier is 1 or 9
          title: Modifier Allowed
        program:
          const: medicaid
          default: medicaid
          title: Program
          type: string
        ptp_edit_rationale:
          anyOf:
            - type: string
            - type: 'null'
          description: CMS edit rationale
          title: Ptp Edit Rationale
        ptp_type:
          anyOf:
            - type: string
            - type: 'null'
          description: 'PTP table: prac, hosp, or dme'
          title: Ptp Type
      required:
        - col1_proc_cd
        - col2_proc_cd
      title: MedicaidPTPResponse
      type: object
    HTTPValidationError:
      properties:
        detail:
          items:
            $ref: '#/components/schemas/ValidationError'
          title: Detail
          type: array
      title: HTTPValidationError
      type: object
    ValidationError:
      properties:
        ctx:
          title: Context
          type: object
        input:
          title: Input
        loc:
          items:
            anyOf:
              - type: string
              - type: integer
          title: Location
          type: array
        msg:
          title: Message
          type: string
        type:
          title: Error Type
          type: string
      required:
        - loc
        - msg
        - type
      title: ValidationError
      type: object
  securitySchemes:
    APIKeyHeader:
      in: header
      name: X-API-Key
      type: apiKey

````