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GET
Validate a code pair for PTP bundling

Authorizations

X-API-Key
string
header
required

Query Parameters

code1
string
required

First procedure code

code2
string
required

Second procedure code

claim_type
string | null

Filter by claim type: prac (professional) or hosp (institutional)

date_of_service
string<date> | null

Date of service (YYYY-MM-DD); selects the NCCI version active on that date.

payer
string | null

Payer slug. medicaid / masshealth / medi_cal selects the CMS Medicaid NCCI file on /validate.

plan_type
string | null

ffs | medicare_advantage | medicaid | commercial

state
string | null

Two-letter US state. With payer=medicaid|masshealth|medi_cal uses the CMS Medicaid NCCI floor for that state.

Response

Successful Response

Result of PTP bundling validation between two codes.

code1
string
required
code2
string
required
is_bundled
boolean
required

Whether the pair has a PTP edit

additional_claim_types
NCCIValidateClaimTypeResult · object[] | null

If multiple claim types have edits for this pair, additional results are listed here

claim_type
string | null

Claim type for this result (professional/institutional)

col1_proc_cd
string | null

Column 1 (comprehensive) procedure code

col2_proc_cd
string | null

Column 2 (component) procedure code

edit_scope
string | null

cms_medicare_national or cms_medicaid_national

effective_date
string | null
modifier_allowed
boolean | null

Whether a modifier can bypass the bundle

modifier_indicator
string | null
payer
string | null

Payer slug that selected the file

program
string | null

medicare or medicaid — which CMS NCCI file was used

ptp_rationale
string | null
state
string | null

Two-letter US state used to scope the query

state_overlay
string | null