API Reference
Look up medical code
Look up a medical code (CPT, HCPCS, ICD-10, NDC) and get coverage information. Returns fuzzy suggestions when exact match fails.
Authorization
bearerAuth AuthorizationBearer <token>
API keys are prefixed with vrt_live_ for production or vrt_test_ for testing.
Example: vrt_live_abc123xyz
In: header
Query Parameters
code*string
The medical code to look up
Length
1 <= length <= 20code_system?string
Hint for code system
Value in
"CPT" | "HCPCS" | "ICD10CM" | "ICD10PCS" | "NDC"jurisdiction?string
Filter policies by MAC jurisdiction code
Length
length <= 10include?string
Comma-separated list of additional data to include: rvu, policies, rates
fuzzy?string
Enable fuzzy matching on miss
Default
"true"Value in
"true" | "false"Response Body
application/json
application/json
application/json
application/json
curl -X GET "https://verity.backworkai.com/api/v1/codes/lookup?code=76942&jurisdiction=JM&include=rvu%2Cpolicies%2Crates"{
"success": true,
"data": {
"code": "76942",
"code_system": "HCPCS",
"found": true,
"description": "Ultrasonic guidance for needle placement",
"short_description": "string",
"category": "string",
"betos_code": "string",
"poa_exempt": true,
"is_active": true,
"rvu": {
"work_rvu": "0.67",
"pe_rvu_nonfacility": "string",
"pe_rvu_facility": "string",
"mp_rvu": "string",
"total_rvu_nonfacility": "string",
"total_rvu_facility": "string",
"non_facility_price": "85.23",
"facility_price": "42.11",
"conversion_factor": "33.4009",
"global_days": "000",
"status_code": "A",
"year": 2025
},
"policies": [
{
"policy_id": "L33831",
"title": "Ultrasound Guidance for Needle Placement",
"policy_type": "LCD",
"disposition": "covered",
"jurisdiction": "JM",
"effective_date": "2024-01-01"
}
],
"suggestions": [
{
"code": "76942",
"code_system": "HCPCS",
"description": "string",
"score": 0.95,
"match_type": "code"
}
],
"negotiated_rates": {
"min_rate": "1.30",
"max_rate": "978.71",
"avg_rate": "193.32",
"num_rates": 28243,
"payer": "United HealthCare Services, Inc.",
"arrangement": "ffs"
},
"ndc_crosswalk": {
"ndc": "00023-1145-01",
"hcpcs_code": "J0585",
"hcpcs_description": "string",
"ndc_label": "Botox",
"route": "Injection",
"billing_units": "string",
"conversion_factor": "string"
}
},
"meta": {
"request_id": "string",
"includes": [
"string"
],
"fuzzy_enabled": true
}
}{
"success": false,
"error": {
"code": "VALIDATION_ERROR",
"message": "Invalid query parameters",
"hint": "Check the 'code' parameter format",
"details": {}
},
"meta": {
"request_id": "req_abc123"
}
}{
"success": false,
"error": {
"code": "VALIDATION_ERROR",
"message": "Invalid query parameters",
"hint": "Check the 'code' parameter format",
"details": {}
},
"meta": {
"request_id": "req_abc123"
}
}{
"success": false,
"error": {
"code": "VALIDATION_ERROR",
"message": "Invalid query parameters",
"hint": "Check the 'code' parameter format",
"details": {}
},
"meta": {
"request_id": "req_abc123"
}
}