ECM Pro™ Label Web Service User’s Guide...The ICD-9-CM labeling methods use the i9title.dat...

V2101.01Last Updated: January 14, 2021 8:54 am

ECM Pro™ Label Web Service User’s Guide

ECM Pro™ Label Web Services User’s Guide

Published January 14, 2021 The format of this document is 8.5 x 11”

© 2021 Optum.

All rights reserved.

This document is protected by copyright law and international treaties. Unauthorized reproduction or distribution of this document, or any portions of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent under the law.

CPT® codes, descriptions, and other CPT® materials obtain a copyright of 2020 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT®. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. CPT® is a registered trademark of the American Medical Association.

Current Dental Terminology, © 2020 American Dental Association. All rights reserved.

Applicable FARS/DFARS Restrictions Apply to Government Use.

3M™ is a trademark of 3M™ Company. The 3M™ Grouper Plus System (3M™ GPS) with the 3M™ Enhanced Ambulatory Patient Grouping System (3M™ EAPGS) its logic are proprietary to 3M™ Company and are subject to the terms and conditions of the software licensing agreement between 3M™ and Optum.

© 2021, American Hospital Association (AHA), Chicago, Illinois. Reproduced with permission. No portion of this publication may be reproduced, sorted in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior express, written consent of AHA.

All Optum trademarks and logos are owned by Optum. All other brand or product names or trademarks are registered marks of their respective owners. Because we are continuously improving our products and services, Optum reserves the right to change specifications without prior notice. Optum is an equal opportunity employer.

EDC Analyzer™ - U.S. Patent No. 10,417,382

Optum11000 Optum Circle

Eden Prairie, MN 55344

[email protected]

Optum | www.optum.com January 14, 2021

Table of ContentsChapter 1: Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

About Optum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Contact Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Chapter 2: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Prior Knowledge Assumed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Overview of Label Web Service Data Files . . . . . . . . . . . . . . . . . . . . . . . 10The Label Web Service Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Hardware/Software Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Chapter 3: Installation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Installing the Label Web Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Default Directory Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Chapter 4: Integration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28Preparing the Input Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Handling the Return Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Data Formatting Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Integrating the Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Configuring the FileReplace Web Service . . . . . . . . . . . . . . . . . . . . . . . . 32Enabling Enhanced Web Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Appendix A: GetShortDXTitle and GetLongDXTitle . . . . . . . . . . . . . . . . . . . . . . 42GetShortDXTitle and GetLongDXTitle Requests . . . . . . . . . . . . . . . . . . . 43GetShortDXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43GetLongDXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Appendix B: GetShortPXTitle and GetLongPXTitle . . . . . . . . . . . . . . . . . . . . . . 45GetShortPXTitle and GetLongPXTitle Requests . . . . . . . . . . . . . . . . . . . 46GetShortPXTitle Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46GetLongPXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Appendix C: GetShortI10DXTitle, GetMediumI10DXTitle, and GetLongI10DXTitle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Get Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49GetShortI10DXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49GetMediumI10DXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50GetLongI10DXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Appendix D: GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Get Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53GetShortI10PXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53GetMediumI10PXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53GetLongI10PXTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Appendix E: GetShortHCPCSTitle and GetLongHCPCSTitle . . . . . . . . . . . . . . 55Get Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56GetShortHCPCSTitle Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56GetLongHCPCSTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Appendix F: GetDRGTitle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57GetDRGTitle Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58


GetDRGTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58Appendix G: GetMDCTitle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

GetMDCTitle Request. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61GetMDCTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Appendix H: GetMDCNumber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62GetMDCNumber Request. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63GetMDCNumber Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Appendix I: GetDXCodesRange, GetPXCodesRange, and GetHCPCSCodesRange . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Get Requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65GetDXCodesRange Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65GetPXCodesRange Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65GetHCPCSCodesRange Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Appendix J: GetShortDXTitleList . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66GetShortDXTitleList Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67GetShortDXTitleList Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Appendix K: GetShortPXTitleList . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68GetShortPXTitleList Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69GetShortPXTitleList Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Appendix L: GetShortHCPCSTitle List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70GetShortHCPCSTitleList Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71GetShortHCPCSTitleList Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Appendix M: GetAPCTitle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72GetAPCTitle Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73GetAPCTitle Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Appendix N: GetAPGTitle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74GetAPGTitle Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75GetAPGTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Appendix O: GetRUGTitle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76GetRUGTitle Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77GetRUGTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

Appendix P: GetHACTitle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78GetHACTitle Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79GetHACTitle Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Chapter Q: FileReplace Structures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80ReplaceFiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Query . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Chapter R: GetCodeLabelArray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82GetCodeLabelArray Request . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83GetCodeLabelArray Response. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

Chapter S: Custom Label Files. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85How to Create Custom File Layouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85


File Names and Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93


1 Overview

ECM Pro™ is an Enterprise Content Management (ECM) system for simplifying the complexities of Coding, Compliance, and Reimbursement Management (CCRM). With the multitude of regulatory content and its disparate and off-cycle release schedules, ECM Pro™ provides a valuable function by removing the heavy lifting associated with remaining current.Through standard ECM practices, ECM Pro™:

• Aggregates content from multiple sources (CMS, AMA, FIs, etc.)• Syndicates content into reusable components such as technology

components, online references, and publicationsDeploys content in standards-based web services components, hyper linked references (APC Assistant™, www.optum.com, Coding Clinic, CDGs, and CPT Assistant™) and other online publications.

1.1 About OptumOptum is a health services business dedicated to making the health system work better for everyone. At Optum, we help modernize the health ecosystem, by bringing inter-operable and connected technology, real-time information, streamlined administration and managed compliance, risk, and costs.

1.2 Contact Us1.2.1 Corporate Address

Optum11000Optum CircleEden Prairie, MN. 55344T 1 + (888) 445-8745www.optum.com

1.2.2 Need Assistance? Contact Optum Client ServicesWe welcome you as a valued client. Please contact Optum Client Services using one of the methods detailed below.When opening a ticket with Optum Client Services you will be issued a ticket number. These ticket numbers correlate to individual issues. If you are experiencing multiple issues, it is recommended that you obtain individual ticket numbers.When calling Optum Client Services regarding a previously opened ticket, have your ticket number available. If you misplaced or did not receive a ticket number, please ask the technician to provide it to you.

http://www.optuminsight.com

http://www.optum.com


Optum Client Services Phone: 800-999-DRGS (3747)1. Calls are answered in the order that they are received. If there is a high

call volume, calls are held in a queue until a technician becomes available.

2. Calls classified as an industry expert category (i.e., case and reimbursement, logic encoder, etc.) will be escalated to Optum experts.

3. Technicians are available 24/7.

After selecting Option 6 for Technical Support you will hear the following choices:

Email: Optum Client.Services1. Include name and number and detailed description of product issue.2. Response time to email is generally within a few business hours.3. Service technician has ability to do prior research before calling back.

1.2.3 Optum Client PortalFor access to announcements, user documentation, notices, release schedules, and much more please visit the Optum Client Portal.

1.2.4 Found an Error in This User’s Guide?Please feel free to contact our EASYGroup™ Documentation Team with any errors you may have found within this user’s guide:EASYGroup_DocumentationWe welcome feedback from our clients.

Table 1-1: Technical Support Options

Option # DescriptionOption 1 For password reset, login issues, or expiration

error.Option 2 For all other issues.

mailto:[email protected]

https://optum.secure.force.com/CustomerPortal

mailto:[email protected]


2 Introduction

This manual provides the technical information needed to install and use the ECM Pro™ Label Web Service. Using this service, a developer writing an application on any web-accessible platform can request:

• Short labels or long labels for ICD-9-CM/ICD-10-CM/PCS diagnosis and procedure codes.

• Short labels, medium labels, or long labels for ICD-10-CM/PCS diagnosis and procedure codes.

• Short labels or long labels for CPT®-4 or HCPCS Level II codes.• Short labels or long labels for CPT®-4 or HCPCS Level II modifiers.• Text descriptions for specific APCs, APGs, CMGs, DRGs, HHRGs, MDCs,

CMGs, RICs, and RUGs.• Text descriptions for Hospital-Acquired Conditions (HACs).

The Label Web Service methods access ICD-9-CM, ICD-10-CM/PCS, and HCPCS Codes and Titles files, and APCs, APGs, CMGs, DRGs, HHRGs, MDCs, CMGs, RICs, RUGs or HACs description files to provide current and accurate code and descriptions based on submitted effective dates. It includes methods to retrieve ICD-9-CM, ICD-10-CM/PCS, and HCPCS labels, and identifies partial codes, rubrics, and codes that are not valid as of the supplied effective date. Finally, the Label Web Service includes methods designed to support web-based interactive applications for browsing codes and code descriptions. This chapter contains the following sections:

• Prior Knowledge Assumed• Overview of Label Web Service Data Files• The Label Web Service Operations• Hardware/Software Requirements


2.1 Prior Knowledge AssumedThis manual assumes that the reader has a functional knowledge of the following:

• Standard web services architecture• SOAP, XML, HTML• ICD-9-CM, ICD-10-CM/PCS, and CPT®-4/HCPCS coding terminology

and procedures• Diagnosis Related Groups (DRGs) and Major Diagnostic Categories

(MDCs)• Ambulatory Payment Classifications (APCs)• Ambulatory Payment Groups (APGs)• Case-Mix Groups (CMGs) and Rehabilitation Impairment Categories

(RICs)• Resource Utilization Groups (RUGs)• Home Health Resource Groups (HHRGs)

The user’s guide also assumes familiarity with standard medical coding and prospective payment terminology. For a more comprehensive review of specific functions, please refer to the EASYGroup™ User’s Guide.


2.2 Overview of Label Web Service Data FilesThe Label Web Service can be summarized in the following diagrams.

Figure 2-1. Label Web Service – ICD-9-CM and HCPCS Operations

Figure 2-2. Label Web Service – ICD-10-CM/PCS Operations

The Label Web Service relies on the following standard reference sources. These data files are stored as standard ASCII text files.

2.2.1 ICD-9-CM, ICD-10-CM/PCS, and HCPCS Codes and Titles Files

The EASYGroup™ ICD-9-CM, ICD-10-CM/PCS, and HCPCS Date-Sensitive Codes and Titles files contain all current and previous codes, with accompanying short (abbreviated to 35 characters), medium (abbreviated 70 characters (ICD-10 only)), and long (complete, up to 255 characters) titles or descriptions. Each code is tagged with a starting and ending date which shows exactly when that particular code or version of the code was valid. Codes valid at the present time have an ending date of all zeroed (00000000). Rubrics or code subparts, which have never been valid for coding, are identified with both a starting and ending date of zeroed. Using the Date-Sensitive Codes and Titles files, the Label Web Service can retrieve the accurate diagnosis and procedure code labels based on date of service. Code descriptions are retrieved based on the type of code (ICD-9-CM diagnosis,


ICD-9-CM procedure, ICD-10-CM diagnosis, ICD-10-PCS procedure, CPT®-4 or HCPCS Level II) and date of service. The ICD-9-CM labeling methods use the i9title.dat file, which is updated every October, with a potential additional update every April. The ICD-10-CM and ICD-10-PCS labeling methods use the i10title.dat file. The HCPCS labeling methods use the hctitle.dat file, which is updated every quarter (October, January, April, and July). File updates are implemented as complete replacements.

2.2.2 APC/APG Description FileThe APC/APG Description file (apgdsc.dat) contains abbreviated 40-character descriptions for each Ambulatory Payment Classification (APC), Ambulatory Payment Group (APG), or Home Health Resource Group (HHRG) for every supported Grouper/Reader type and version. Supported Grouper or Reader types and versions include Medicare, TRICARE, plus a number of state-specific Groupers used for the payment of Medicaid. Descriptions are retrieved based on Grouper/Reader type, version, and date of service. The GetAPCTitle and GetAPGTitle methods use the apgdsc.dat file, which is generally updated every time a new Grouper or Grouper version becomes available.

2.2.3 DRG/CMG Description FileThe DRG/CMG Description file (drgdsc.dat) contains abbreviated 40-character descriptions for each Diagnosis Related Group for every supported Grouper type and version. Supported Grouper types and versions include Medicare, TRICARE, AP-DRG, APS-DRGs®, plus a number of state-specific Groupers used for the payment of Medicaid or Worker’s Compensation claims. It also contains abbreviated 40-character descriptions for each Case-Mix Group (CMG) for the IRF/CMG Grouper versions 04 and up. Descriptions are retrieved based on Grouper type, Grouper version, and date of service. The GetDRGTitle method uses the drgdsc.dat file, which is updated every time a new Grouper or Grouper version becomes available.

2.2.4 MDC/RIC Description FileThe MDC/RIC Description file (mdcdsc.dat) contains abbreviated 40-character descriptions for each Major Diagnostic Category (MDC) or Rehabilitation Impairment Category (RIC) for every supported Grouper type and version. Supported Grouper types and versions include Medicare, TRICARE, AP-DRG, APS-DRGs®, plus a number of state-specific Groupers used for the payment of Medicaid or Worker’s Compensation claims. This file also contains abbreviated descriptions for each Rehabilitation Impairment Category (RIC). Descriptions are retrieved based on Grouper type, Grouper version, and date of service. The GetMDCTitle method uses the mdcdsc.dat file, which is also updated every time a new Grouper type or Grouper version becomes available.


2.2.5 RUG Description FileThe RUG Description file (rugdsc.dat) contains abbreviated 40-character descriptions for each Resource Utilization Group for Medicare Skilled Nursing facilities. Descriptions are retrieved based on Grouper/Reader type and version. The GetRUGTitle method uses the rugdsc.dat file.

2.2.6 HAC Description FileThe HAC description file (hacdsc.dat) contains 100-byte descriptions for each Hospital-Acquired Condition (HAC). Descriptions are retrieved based on the HAC number.

2.2.7 Overview of the FileReplace Web ServiceThe FileReplace Web Service, available within the Labels Web Service, allows users to replace rate files without having to reset the Internet Information Server (IIS). Unlike other ECM Pro™ Web Services the FileReplace Web Service possesses a User Interface (UI), for ease of use and to foster an enhanced user experience.

Figure 2-3. FileReplace User Interface

For further information on the FileReplace UI and instructions on how to configure the FileReplace Web Service please refer to the Integration section.


The FileReplace Web Service is utilized by the following three methods:• ReplaceFiles - Replaces the files found in the New directory. This is the

primary method of the FileReplace Web Service and is the method that will relocate all rate files the user wishes to replace.

• Query - Retrieves the file information for the files currently being used by the Optimizer (i.e., the IOCONTROL control program). This method will indicate which files are currently open and in use by the Optimizer. Files set to zero (0) will alert the user that the file is currently active.

• Search - Retrieves the file information for the files located in the New directory. This method indicates which files will be replaced by the FileReplace Web Service. The user will be able to see what files are out on the Server without connecting to the Server.

NoteFor a for further details on the layouts of the FileReplace Web Service methods please refer to FileReplace Structures section.

The FileReplace Web Service Structure is illustrated below.


2.3 The Label Web Service OperationsThe operations (methods) that comprise the Label Web Service are described below. Each operation can be used independently.

• GetShortDXTitle and GetLongDXTitle (refer to Appendix A)• GetShortPXTitle and GetLongPXTitle (refer to Appendix B)• GetShortI10DXTitle, GetMediumI10DXTitle, and GetLongI10DXTitle (refer

to Appendix C)• GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle (refer

to Appendix D)• GetShortHCPCSTitle and GetLongHCPCSTitle (refer to Appendix E)• GetDRGTitle (refer to Appendix F)• GetMDCTitle (refer to Appendix G)• GetMDCNumber (refer to Appendix H)• GetDXCodesRange, GetPXCodesRange, and GetHCPCSCodesRange

(refer to Appendix I)• GetShortDXTitleList (refer to Appendix J)• GetShortPXTitleList (refer to Appendix K)• GetShortHCPCSTitleList (refer to Appendix L)• GetAPCTitle (refer to Appendix M)• GetAPGTitle (refer to Appendix N)• GetRUGTitle (refer to Appendix O)• GetHACTitle (refer to Appendix P)• FileReplace Web Service (refer to Appendix Q)


Input and output requirements for each operation below are listed in the associated ASMX file(s) using WSDL (supplied with your distribution). These requirements are also defined in separate appendices within this manual.

• GetShortDXTitleSubmit an ICD-9-CM diagnosis code and service or discharge date and retrieve the appropriate short (abbreviated) title for that date.

• GetShortPXTitleSubmit an ICD-9-CM procedure code and service date and retrieve the appropriate short (abbreviated) title for that service date.

• GetShortHCPCSTitleSubmit a HCPCS Level I or Level II code and service date and retrieve the appropriate short (abbreviated) title for that service date.

• GetLongDXTitleSubmit an ICD-9-CM diagnosis code and service or discharge date and retrieve the appropriate long title for that service date.

• GetLongPXTitleSubmit an ICD-9-CM procedure code and service date and retrieve the appropriate long title for that service date.

• GetLongHCPCSTitleSubmit a HCPCS Level I or Level II code and service date and retrieve the appropriate long title for that service date.

• GetDRGTitleSubmit a DRG or CMG, Grouper type and Grouper version and retrieve the appropriate DRG or CMG description.

• GetMDCTitleSubmit an MDC or RIC, Grouper type and Grouper version and retrieve the appropriate MDC or RIC description.

• GetMDCNumberSubmit a DRG or CMG, Grouper type and Grouper version and retrieve the appropriate MDC or RIC number.

• GetDXCodesRangeRetrieve the first and last code in the ICD-9-CM diagnosis table.

• GetPXCodesRangeRetrieve the first and last code in the ICD-9-CM procedure table.

• GetHCPCSCodesRangeRetrieve the first and last code in the combined HCPCS Level I and Level II table.


• GetShortDXTitleListSubmit the a ICD-9-CM diagnosis, service date, and list size and retrieve a sequential list of ICD-9-CM diagnosis codes and their short titles, of the specified size, starting with the specified ICD-9-CM diagnosis code.

• GetShortPXTitleListSubmit the a ICD-9-CM procedure, service date, and list size and retrieve a sequential list of ICD-9-CM procedure codes and their short titles, of the specified size, starting with the specified ICD-9-CM procedure code.

• GetShortHCPCSListSubmit the a HCPCS Level I or HCPCS Level II code, service date, and list size and retrieve a sequential list of HCPCS codes and their short titles, of the specified size, starting with the specified HCPCS Level I or HCPCS Level II code.

• GetAPCTitleSubmit an APC or HHRG, Grouper/Reader type and version and retrieve the appropriate APC or HHRG description.

• GetAPGTitleSubmit an APG, Grouper type and Grouper version and retrieve the appropriate APG description.

• GetShortI10PXTitleSubmit an ICD-10-PCS procedure and service date and retrieve the appropriate short (abbreviated) title for that service date.

• GetMediumI10PXTitleSubmit an ICD-10-PCS procedure and service date and retrieve the appropriate medium (abbreviated) title for that service date.

• GetLongI10PXTitleSubmit an ICD-10-PCS procedure and service date and retrieve the appropriate long title for that service date.

• GetShortI10DXTitleSubmit an ICD-10-CM diagnosis code and service or discharge date and retrieve the appropriate short (abbreviated) title for that service date.

• GetMediumI10DXTitleSubmit an ICD-10-CM diagnosis code and service or discharge date and retrieve the appropriate medium (abbreviated) title for that service date.

• GetLongI10dXTitleSubmit an ICD-10-CM diagnosis code and service or discharge date and retrieve the appropriate long title for that service date.


• GetRUGTitleSubmit a RUG, Grouper/Reader type and version and retrieve the appropriate RUG description.

• GetHACTitleSubmit an HAC number and retrieve the appropriate HAC description.

2.4 Hardware/Software RequirementsTo use the ECM Pro™ Label Web Service, your operating environment must meet or exceed the following hardware and software requirements:

• Hardware- Processor: 1GHz Pentium or equivalent (Minimum); 2.4GHz Dual

Pentium (Recommended) - RAM: 1GB (Minimum); 2GB or higher (Recommended) - Hard Disk: 5 GB available space (Minimum); 10 GB available space

(Recommended) - Network Adapter: 100BASE-T (Minimum); 1000BASE-T

(Recommended) • Software

- Windows® Server 2008 (including R2) Service Pack 2 (SP2), 32-bit and 64-bit

- Windows® Server 2012 (including R2) Service Pack 2 (SP2), 64-bit - Windows® 7 Service Pack 1 (SP1), 64-bit- Microsoft®.NET Framework 3.5 (Minimum); Microsoft® .NET

Framework 4.5 Service Pack 1 (Recommended) - Internet Information Services (IIS) 7.0, 7.5, 8.0, and 8.5.

NoteFor further information on installation requirements please refer to the EASYGroup™ Installation Guide.


3 Installation

This chapter contains the following sections:• Installing the Label Web Service• Default Directory Structure


3.1 Installing the Label Web ServiceThe Label Web Service installer (WS_Label_Vnnnn.exe) will take users through the installation process and will prompt users to select a destination directory/folder for the methods (.asmx), the web service description file (.wsdl), and associated components.

NoteFor new installations, the Label Web Service may be installed on drives other than the C: drive. Updates to previous installations, will re-install the Label Web Service to the formerly identified location.

The steps below detail this installation process:1. Download the Label Web Service from the Optum Update Wizard or

the Optum Client Portal. Double-click on the WS_Label_Vvvvv.vv.exe file to invoke the installation sequence.

2. Install Shield will begin to prepare the wizard for the web service installation.

3. When the Install Shield is ready, the following Welcome screen will appear.








Figure 3-1. Welcome Screen

4. Terminate the setup at anytime during the installation process by clicking on the Cancel button. To continue, click on the Next button to view the License Agreement.


Figure 3-2. License Agreement Screen

5. To return to a previous step, simply click on the Back button at any time. Read the License Agreement completely. To continue with the setup process, select the I accept the license agreement, required to continue this install radio button and then select Next to agree with the terms specified.

6. Next, the Choose Destination Location screen will appear. To select a location other than the C: drive select the Browse button. Select Next when finished.

NoteThe Choose Destination Location screen will be displayed during new installations only.


Figure 3-3. Choose Destination Location Screen

7. The Setup Status screen will now appear indicating the progress of the web service installation.


Figure 3-4. Setup Status Screen: Installing Web Service Files

8. After installing the web service files, the Install Shield will then load the Microsoft® .NET framework which is required to run .NET-based web applications or services.


Figure 3-5. Setup Status Screen: Configuring Virtual Directories

9. When the .NET framework has finished loading, the following screen will appear. Click on the Finish button to complete the installation/ setup process.


Figure 3-6. InstallShield Wizard Complete Screen

NoteRefer to the Default Directory Structure section for details on the locations of all web service files.

3.2 Default Directory StructureThe Label Web Service components will be installed in the following directories:

C:\Inetpub\wwwroot\HSS\\Label: This sub-directory contains all of the Label Web Service executables.\Data: This sub-directory contains all data files required by the Label Web Service.\FileReplace: This sub-directory contains the FileReplace Web Service.


\FileReplaceHelper: This sub-directory contains the FileReplace Helper .dll files which can be useful if multiple application pools are being utilized.\FileReplaceUI: This sub-directory contains the files needed for the FileReplace Web Service User Interface (UI).

NoteThe three files listed above for the FileReplace Web Service will be assigned to the same application pool where the user’s current ECM Pro™ Labels Web Service is configured.


4 Integration

After installing the Label Web Service, the application invoking this service will need to be modified. Typically, integration of the Label Web Service methods within a host application involves the following steps:

1. Assemble the required input data2. Determine how to handle the return data3. Create the appropriate calls to the Label Web Service operations.

This chapter contains the following sections:• Preparing the Input Data• Handling the Return Data• Data Formatting Conventions • Integrating the Service • Configuring the FileReplace Web Service• Enabling Enhanced Web Security


4.1 Preparing the Input DataRetrieving code labels typically requires an ICD-9-CM/ICD-10-CM diagnosis, ICD-9-CM/ICD-10-PCS procedure code, or a CPT®-4 or HCPCS Level II code. Each code requires an effective date to allow the Label Web Service to return the accurate label for that date. If no date is submitted, the current date is assumed.Requesting labels for APCs, APGs, CMGs, DRGs, MDCs, or RICs requires the APCs, APGs, CMGs, DRGs, MDCs, or RICs code plus identification of Grouper type and Grouper version. Requesting labels for RUGs or HHRGs requires the Reader type and version.Requesting labels for HACs requires the HAC code (returned by the Date-Sensitive Code (DSC) Editor).

4.2 Handling the Return DataThe returned information from the Label Web Service will depend on the method invoked. If requesting ICD-9-CM, ICD-10-CM, ICD-10-PCS, or HCPCS code labels, it must be determined if the application requires abbreviated titles (35 or 70 characters) or the full titles (up to 255 characters). Invalid codes will generate a label of Code Not Found and codes that are invalid based on the submitted effective date will generate a returned label of Code Not Found for Date. ICD-9-CM and ICD-10-CM codes that require further qualification will return the requested label, but will also generate a true response in the requires_further_qualification indicator. The APCs, APGs, CMGs, DRGs, HHRGs, MDCs, RICs, RUGs titles are only available in the 40-character format. Invalid APCs, APGs, CMGs, DRGs, HHRGs, MDCs, RICs, RUGs that are invalid based on the requested Grouper/Reader type and version will generate a returned label of Label Not Found.The HAC titles are only available in the 100-character format. Invalid HACs will generate a returned label of Label Not Found.

4.3 Data Formatting Conventions The following conventions are used for input and returned parameters for all ECM Pro™ Web Services:

4.3.1 Input FieldsNote

For all input fields, all leading and trailing spaces are removed prior to any other action.

• Text. Any leading or trailing spaces will be removed. Maximum length provided below.


• Fixed length text. Text string, leading spaces removed, required length provided below. If required length is not provided, spaces will be added on the right.

• Numeric text. Treat as fixed length text. Leading zeros required. Required length provided below. All case-mix indicators (DRG, CMG, MDC, APC, APG, HHRG, and RUG) should be treated as numeric text. If required length is not provided, zeros will be added on the left.

• Integers. Numeric fields without decimals. Leading zeros not required. Maximum size provided below.

• Dollars. Leading zeros not required. Decimal not required. If no decimal is supplied, input is assumed to be in whole dollars. If decimal is supplied, zeros will be added on the right if necessary (e.g. 1.00, 1.50). Maximum size for all dollar fields is 9(8)v9(2).

• Decimals. Leading zeros not required. Exact number of digits after the decimal is specified below. Maximum number of digits before the decimal is specified below. Decimal not required. If no decimal is supplied, decimal will be assumed based on field specifications below. If decimal is supplied, zeros will be added on the right if necessary.

• ICD-9-CM codes. Left-justified. Decimals not required but may be submitted. Maximum length is six bytes.

• ICD-10-CM codes. Left-justified. Decimals not required but may be submitted. Maximum length is eight bytes with decimal.

• ICD-10-PCS codes. Left-justified. No decimals. Maximum length is seven bytes.

• HCPCS or HIPPS codes. Five alphanumeric characters, no decimals.• Dates. Eight digits, yyyymmdd format.• Boolean. Numeric switch variable, 1=yes/true, 0=no/false.


4.3.2 Output Fields:• Text. Any leading or trailing spaces will be removed. Maximum length

provided below. A blank result will be returned as an empty string.• Fixed length text. Text string, leading spaces removed, required length

provided below.• Numeric text. Treat as fixed length text. Leading zeros included. Required

length provided below. All case-mix indicators (DRG, CMG, MDC, APC, APG, HHRG, and RUG) will be treated as numeric text.

• Integers. Numeric fields without decimals. Leading zeros not included. Maximum size provided below. All error counts will be treated as integers.

• Dollars. The web service pricing operations will return dollar fields (marked here with a $$) without leading zeros, with explicit decimals, followed by two digits including any trailing zeros (e.g. “125.62” or “12.50” or “1250.00”), and zero dollars will be returned as “0.00”. Maximum size for all dollar fields is 9(8)v9(2).

• Decimals. Leading zeros not required. Decimal will be included, plus the exact number of digits after the decimal, and up to the maximum number of digits before the decimal, as specified below.

• ICD-9-CM codes. Left justified. Decimals will be supplied. Maximum length is six bytes.

• ICD-10-CM codes. Left-justified. Decimals will be supplied. Maximum length is seven bytes.

• ICD-10-PCS codes. Left-justified. Maximum length is eight bytes.• HCPCS or HIPPS codes. Five alphanumeric characters, no decimals.• Error codes. These will be returned as fixed length numeric fields.

Required length is supplied below.• Error messages. These will be returned as text fields. Format of error

messages includes the error code, a space, plus a text description. Error codes will be numeric text fields, with a required length specified below. For the descriptions, no maximum length is specified, but error descriptions are supplied below.

• Repeating error codes. For error arrays (claim level, admit diagnosis, diagnosis, and procedure-related errors), only errors (non-zero entries) will be returned. The number of errors returned will equal the supplied error count. (For example, claim level errors can occur up to 15 times. If the claim level error count is 3, the returned data will include 3 non-zero entries but will not include 12 entries of zeros).

• Repeating error messages. For error message arrays (claim level, admit diagnosis, diagnosis, and procedure-related errors), only errors (non-blank entries) will be returned. The number of errors returned will equal the supplied error count. (For example, claim level errors can occur up to 15


times. If the claim level error count is 3, the returned data will include 3 messages only.)

• Negative numeric or decimal fields. These will be returned with an explicit negative sign e.g. “-450.25.”

4.4 Integrating the Service Integration of Web Services into a client application generally consists of the following steps. Note that this manual assumes familiarity with the architecture and use of Web Services.

• Discovering and Gathering Information about the Service: Browse to the Label.asmx file in the “Label” folder (by default C:\Inetpub\wwwroot\HSS\Label). The HTML Description Page is displayed. This page provides the information required to request the Web Service and test the methods in the service. Click the Service Description link on the page or go to *.asmx?WSDL (with the appropriate address) using a web browser. An XML formatted file is displayed which describes the mechanism for providing the service to any client using SOAP or HTTP.

• Generating a Proxy Class of the Service and Using the Created Proxy Class to Invoke an Available Service: To serialize and de-serialize SOAP messages for various transport protocols, create proxy or “stub” objects using web application development tools that are specific to the application development and run-time environment.

• Writing an Interface for the Service: Creating an instance of the generated proxy class provides access to all the methods of the Label Web Service. The appropriate arguments have to be provided for each chosen operation, and each desired operation must be invoked. The results of the requested operation are returned to the client application and become available for further processing.

4.5 Configuring the FileReplace Web ServiceInitially, the user should manually create both the New and Old directories; which will be located within the \\inetpub\wwwroot\hss\Data directory (or other user-selected location where rate files are stored). The user will then copy updated rate files into the New folder. The FileReplace Web Service includes a User Interface (UI), that the user will then need to access (//localhost/HSS/FileReplaceUI/FileReplaceUI.aspx). The below steps should then be followed.


NoteFiles can only be replaced when they become free from IOCNTRL. Once the replaced files are saved to the New directory, they will then be available for claims processing.

1. Open the FileReplace UI (//localhost/HSS/FileReplaceUI/FileReplaceUI.aspx).

Figure 4-1. FileReplace User Interface (UI)

2. Enter or select the path where you would like to replace files, by

selecting the Browse button next to the Rate Path field or by using the Search Tree on the right-hand side of the screen.


Figure 4-2. Search Tree

Figure 4-3. Enter Rate Path

3. When path is selected, enter any notes in the Notes section that you would like to be saved in the FileReplace.log file. Notes will appear as shown below in the FileReplace.log file.

Figure 4-4. Example of Notes Shown in FileReplace.log File

4. Next, select the File Replace button; which will invoke the FileReplace Web Service.

5. Updated rate files will then be moved into place when they become free from IOCNTRL.

6. Replaced files will be moved into the Old directory to preserve rate history.

7. The logging information will be displayed in the File Replace Log section of the screen. An example is shown below.


Figure 4-5. File Replace Log Screen

8. A FileReplace.log file will also be created in the root Data directory.

Figure 4-6. Example of FileReplace.log File


9. Once the All files replaced! message is displayed, the updated rate files are now available for claims processing.

Figure 4-7. All Files Replaced Message in UI

4.6 Enabling Enhanced Web SecurityIf you wish to enable Internet Information Services (IIS) Digest and Windows Authentication for the Label Web Service you may do so by following the below instructions. Once these features are enabled, you will be prompted to log-in with a user name and password when launching the Label Web Service. The Windows Authentication feature will allow you to be connected immediately to the Label Web Service if you are already logged into Microsoft® Windows®.

NoteThese instructions are optional, but Optum strongly suggests that they are implemented to fully secure the Label Web Service.

1. Navigate to Start>Control Panel>Program and Features.2. Select Turn Windows features on or off from the menu on the left-

hand side of the screen.


Figure 4-8. Program and Features Screen

3. You should now see the Windows Features screen. In this screen, select the check box next to Internet Information Services (IIS) and expand the options, as shown below.


Figure 4-9. Windows Features Screen

4. Check the boxes next to Basic Authentication, Digest Authentication, and Windows Authentication (if desired).

5. Select OK when complete.6. Open the IIS Manager: Start>Control Panel>Administrative

Tools>Internet Information Services (IIS).7. Once you have the IIS Manager screen open, select Authentication

from the main window.


Figure 4-10. Authentication Option

8. You should now see the Authentication window.

Figure 4-11. Enable Digest Authentication for the Label Web Service


9. In this window enable Digest Authentication for the Label Web Service as shown above.

10. Once Digest Authentication has been enabled for the Label Web Service, you will be prompted for a user name and password once the Label Web Service is launched.

Figure 4-12. Log-in Dialog Box

11. Next, navigate back to the Authentication window and enable Windows Authentication (if desired) for the Label Web Service, as shown below.


Figure 4-13. Enable Windows Authentication for the Label Web Services

12. Once the above steps are completed, you will immediately be connected once you launch the Label Web Service if you are already logged into Microsoft® Windows®.

NoteOnce the above features have been enabled you will need to re-start Windows® for them to take effect.


A GetShortDXTitle and GetLongDXTitle

This section provides descriptions for the GetShortDXTitle and GetLongDXTitle methods. For these methods, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.

NoteFor web service requests, please conform to standard web service parameter passing conventions, the field definitions in the ASMX and WSDL files, and the input and output parameter formatting conventions described in Chapter 4.

This appendix includes the following sections:• GetShortDXTitle and GetLongDXTitle Requests• GetShortDXTitle Response• GetLongDXTitle Response


A.1 GetShortDXTitle and GetLongDXTitle RequestsThe following table details the input parameters for the GetShortDXTitle and GetLongDXTitle requests.

A.2 GetShortDXTitle ResponseThe following table details the return parameters for the GetShortDXTitle response.

Table A-1: GetShortDXTitle and GetLongDXTitle Requests

Field Description Format Variable Name NotesCode X(9) DXCode ICD-9-CM diagnosis code. Left-justified,

with or without embedded decimal. Date 9(8) EffDate YYYYMMDD. Discharge date or applicable

service date. If no date is supplied, this operation will return the most recent valid label for the code.

Table A-2: GetShortDXTitle Response

Field Description Format Variable Name NotesAbbreviated Title character title Abbreviated (24-character maximum)

description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is not valid for the submitted effective date, the response is “CODE NOT FOUND FOR DATE”. If the submitted code is a rubric or partial code, the full label will be returned, but the requires_further_qualification flag will be set to “yes”.

Requires Further Qualification Flag

boolean requires_further_qualification

If true, code requires an additional fourth, fifth, sixth, and seventh digit.

Present on Admission Exempt Flag

boolean exempt_from_poa_reporting

If true, code is exempt from present on admission reporting.

Medicare CC Indicator

character medicare_cc_indicator

Y = Diagnosis code is a Medicare CCM = Diagnosis code is a Medicare MCCDefault = Blank


A.3 GetLongDXTitle ResponseThe following table details the return parameters for the GetLongDXTitle response.

Table A-3: GetLongDXTitle Response

Field Description Format Variable Name NotesFull Title character title Full (255-character maximum) description

for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is not valid for the submitted effective date, the response is “CODE NOT FOUND FOR DATE”. If the submitted code is a rubric or partial code, the full label will be returned, but the requires_further_qualification flag will be set to “yes”.




Present On Admission Exempt Flag







B GetShortPXTitle and GetLongPXTitle

This section provides descriptions for the GetShortPXTitle and GetLongPXTitle methods. For these methods, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetShortPXTitle and GetLongPXTitle Requests• GetShortPXTitle Response• GetLongPXTitle Response


B.1 GetShortPXTitle and GetLongPXTitle RequestsThe following table details the input parameters for the GetShortPXTitle and GetLongPXTitle requests.

B.2 GetShortPXTitle ResponseThe following table details the return parameters for the GetShortPXTitle response.

Table B-1: GetShortPXTitle and GetLongPXTitle Requests

Field Description Format Variable Name NotesCode X(9) PXCode ICD-9-CM procedure code. Left-justified,



Table B-2: GetShortPXTitle Response

Field Description Format Variable Name NotesAbbreviated Title Character title Abbreviated (24-character maximum)



Boolean requires_further_qualification



Boolean exempt_from_poa_reporting

Not used for procedures.


B.3 GetLongPXTitle ResponseThe following table details the return parameters for the GetLongPXTitle response.

Table B-3: GetLongPXTitle Response

Field Description Format Variable Name NotesFull Title Character title Complete (255-character maximum)









C GetShortI10DXTitle, GetMediumI10DXTitle, and GetLongI10DXTitle

This section provides descriptions for the GetShortI10DXTitle, GetMediumI10DXTitle, and GetLongI10DXTitle methods. For these methods, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• Get Requests• GetShortI10DXTitle Response• GetMediumI10DXTitle Response• GetLongI10DXTitle Response


C.1 Get RequestsThe following table details the input parameters for the GetShortI10DXTitle, GetMediumI10DXTitle, and GetLongI10DXTitle requests.

C.2 GetShortI10DXTitle ResponseThe following table details the return parameters for the GetShortI10DXTitle response.

Table C-1: GetShortI10DXTitle, GetMediumI10DXTitle and GetLongDXI10Title Requests

Field Description Format Variable Name NotesCode X(9) DXCode ICD-10-CM diagnosis code. Left-justified,



Table C-2: GetShortI10DXTitle Response











ICD-10-CM Diagnosis Only:Y = Diagnosis code is a Medicare CCM = Diagnosis code is a Medicare MCCDefault = Blank

Hospital Acquired Condition (HAC) Indicator

character hac_ind If true, code is on one of the CMS Hospital Acquired Condition (HAC) lists.


C.3 GetMediumI10DXTitle ResponseThe following table details the return parameters for the GetMediumI10DXTitle response.

C.4 GetLongI10DXTitle ResponseThe following table details the return parameters for the GetLongI10DXTitle response.

Table C-3: GetMediumI10DXTitle Response














Table C-4: GetLongI10DXTitle Response

Field Description Format Variable Name NotesFull Title character title Full (255-character maximum) description

for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is not valid for the submitted effective date, the response is “CODE NOT FOUND FOR DATE”. If the submitted code is a rubric or partial code, the full label will be returned, but the requires_further_qualification flag will be set to “yes”.













Table C-4: GetLongI10DXTitle Response

Field Description Format Variable Name Notes


D GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle

This section provides descriptions for the GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle methods. For these methods, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• Get Requests• GetShortI10PXTitle Response• GetMediumI10PXTitle Response• GetLongI10PXTitle Response


D.1 Get RequestsThe following table details the input parameters for the GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle requests.

D.2 GetShortI10PXTitle ResponseThe following table details the return parameters for the GetShortI10PXTitle response.

D.3 GetMediumI10PXTitle ResponseThe following table details the return parameters for the GetMediumI10PXTitle response.

Table D-1: GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle Requests

Field Description Format Variable Name NotesCode X(9) PXCode ICD-10-PCS procedure code. Left-justified. Date 9(8) EffDate YYYYMMDD. Discharge date or applicable


Table D-2: GetShortI10PXTitle Response


description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is not valid for the submitted effective date, the response is “CODE NOT FOUND FOR DATE”.

Requires Further Qualification FlagReserved


Reserved




Table D-3: GetMediumI10PXTitle Response




D.4 GetLongI10PXTitle ResponseThe following table details the return parameters for the GetLongI10PXTitle response.



Reserved




Table D-3: GetMediumI10PXTitle Response


Table D-4: GetLongI10PXTitle Response

Field Description Format Variable Name NotesFull Title Character title Complete (255-character maximum)




Reserved





E GetShortHCPCSTitle and GetLongHCPCSTitle

This section provides descriptions for the GetShortHCPCSTitle and GetLongHCPCSTitle methods. For these methods, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• Get Requests• GetShortHCPCSTitle Response• GetLongHCPCSTitle Response


E.1 Get RequestsThe following table details the input parameters for the GetShortHCPCSTitle and GetLongHCPCSTitle requests.

E.2 GetShortHCPCSTitle ResponseThe following table details the return parameters for the GetShortHCPCSTitle response.

E.3 GetLongHCPCSTitle ResponseThe following table details the return parameters for the GetLongHCPCSTitle response.

Table E-1: GetShortHCPCSTitle and GetLongHCPCSTitle Requests

Field Description Format Variable Name NotesCode X(9) HCPCSCode HCPCS Level I, Level II or modifier. A

modifier title is returned if “099” is prefixed to the required modifier code. Left-justified, five characters required.

Date 9(8) EffDate YYYYMMDD. Service date. If no date is supplied, this operation will return the most recent valid label for the code.

Table E-2: GetShortHCPCSTitle Response

Field Description Format Variable Name NotesAbbreviated Title Character GetShortHCPCS

TitleResultAbbreviated (24-character maximum) description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is invalid for the submitted service date, response is “CODE NOT FOUND FOR DATE”.

Table E-3: GetLongHCPCSTitle Response

Field Description Format Variable Name NotesFull Title Character GetLongHCPCS

TitleResultComplete (255-character maximum) description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is invalid for the submitted service date, response is “CODE NOT FOUND FOR DATE”.


F GetDRGTitle

This section provides descriptions for the GetDRGTitle method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetDRGTitle Request• GetDRGTitle Response


F.1 GetDRGTitle RequestThe following table details the input parameters for the GetDRGTitle request.

F.2 GetDRGTitle ResponseThe following table details the return parameters for the GetDRGTitle response.

Table F-1: GetDRGTitle Request

Field Description Format Variable Name NotesDRG or CMG Numeric DRG DRG or CMG code. Leading zeroes are

not required.Grouper Type Character grouper_type Grouper type can be submitted as follows:

01: CMS (Medicare Inpatient)02: APDRG (All-Patient)03: CHAMPUS (TRICARE)06: WIMD (Wisconsin Medicaid)07: NCMD (North Carolina Medicaid)08: OHIOMD (Ohio Medicaid)09: APS-DRGs® (All Payer Severity-

Adjusted)10: APRDRG (All Patient Refined)11: ICD10CMS (Medicare Inpatient ICD-

10)90: IRF (Medicare Rehab CMGs)

Grouper Version Numeric grouper_version Generally, Grouper version numbers conform to the following convention:

27: FY2010 for the Medicare Inpatient Grouper, for example.

For IRF/CMG Grouper versions are as follows:

09: FY 2010 IRF Grouper, for example.

Table F-2: GetDRGTitle Response

Field Description Format Variable Name NotesDRG Title Character DRGTitleResult Abbreviated (40-character maximum)

description for the supplied DRG or CMG. If the code is invalid, or not valid for the specified Grouper type or version, the response is “LABEL NOT FOUND.”

Medical/Surgical DRG Indicator

Numeric medsurg_ind Blank = Ungroupable1 = Surgical2 = Medical

CC/MCC Indicator Numeric cc_ind Blank = None1 = CC2 = MCC3 = CC/MCC


Pair/Triplet Indicator Numeric pairtrip_ind Blank = None2 = Pair3 = Triplet

Pair/Triplet Group Character pairtrip_grp Blank = No pair/triplet groupXXXX XXXX = Pair code groupXXXX XXXX XXXX = Triplet pair group

Table F-2: GetDRGTitle Response



G GetMDCTitle

This section provides descriptions for the GetMDCTitle method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetMDCTitle Request• GetMDCTitle Response


G.1 GetMDCTitle RequestThe following table details the input parameters for the GetMDCTitle request.

G.2 GetMDCTitle ResponseThe following table details the return parameters for the GetMDCTitle response.

Table G-1: GetMDCTitle Request

Field Description Format Variable Name NotesMDC or RIC Numeric MDC MDC or RIC code. Leading zeroes are not

required. Grouper Type Character grouper_type Grouper type can be submitted as a

number.01: CMS (Medicare Inpatient)02: APDRG (All-Patient)03: CHAMPUS (Tricare)06: WIMD (Wisconsin Medicaid)07: NCMD (North Carolina Medicaid)08: OHIOMD (Ohio Medicaid)09: APS-DRG® (All Payer Severity-







Table G-2: GetMDCTitle Response

Field Description Format Variable Name NotesMDC or RIC Title Character GetMDCTitle

ResultAbbreviated (40-character maximum) description for the supplied MDC or RIC. If the code is invalid, or not valid for the specified Grouper type or version, the response is “LABEL NOT FOUND”.


H GetMDCNumber

This section provides descriptions for the GetMDCNumber method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetMDCNumber Request• GetMDCNumber Response


H.1 GetMDCNumber RequestThe following table details the input parameters for the GetMDCNumber request.

H.2 GetMDCNumber ResponseThe following table details the return parameters for the GetMDCNumber response.

Table H-1: GetMDCNumber Request

Field Description Format Variable Name NotesDRG or CMG Numeric DRG DRG or CMG code. Leading zeroes are

not required. Grouper Type Character grouper_type Grouper type can be submitted as follows:

01: CMS (Medicare Inpatient)02: APDRG (All-Patient)03: CHAMPUS (Tricare)06: WIMD (Wisconsin Medicaid)07: NCMD (North Carolina Medicaid)08: OHIOMD (Ohio Medicaid)09: APS-DRGs® (All Payer Severity-







Table H-2: GetMDCNumber Response

Field Description Format Variable Name NotesMDC or RIC Numeric GetMDCNumber

ResultTwo-character MDC or RIC code. Leading zeroes are included.


I GetDXCodesRange, GetPXCodesRange, and GetHCPCSCodesRange

This section provides descriptions for the GetDXCodesRange, GetPXCodesRange, and GetHCPCSCodesRange methods. For these methods, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• Get Requests• GetDXCodesRange Response• GetPXCodesRange Response• GetHCPCSCodesRange Response


I.1 Get RequestsNo input is necessary for the GetDXCodesRange, GetPXCodesRange, and GetHCPCSCodesRange methods.

I.2 GetDXCodesRange ResponseThe following table details the return parameters for the GetDXCodesRange.

I.3 GetPXCodesRange ResponseThe following table details the return parameters for the GetPXCodesRange.

I.4 GetHCPCSCodesRange ResponseThe following table details the return parameters for the GetHCPCSCodesRange.

Table I-1: GetDXCodesRange Response

Field Description Format Variable Name NotesFirst Code Character first_code The first code in the ICD-9-CM Diagnosis

table. Left-justified, without embedded decimal.

Last Code Character last_code The last code in the ICD-9-CM Diagnosis table. Left-justified, without embedded decimal.

Table I-2: GetPXCodesRange Response

Field Description Format Variable Name NotesFirst Code Character first_code The first code in the ICD-9-CM procedure

table. Left-justified, without embedded decimal.

Last Code Character last_code The last code in the ICD-9-CM procedure table. Left-justified, without embedded decimal.

Table I-3: GetHCPCSCodesRange Response

Field Description Format Variable Name NotesFirst Code Character first_code The first code in the HCPCS code table.Last Code Character last_code The last code in the HCPCS code table.


J GetShortDXTitleList

This section provides descriptions for the GetShortDXTitleList method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetShortDXTitleList Request• GetShortDXTitleList Response


J.1 GetShortDXTitleList RequestThe following table details the input parameters for the GetShortDXTitleList request.

J.2 GetShortDXTitleList ResponseThe following table details the return parameters for the GetShortDXTitleList response.

Table J-1: GetShortDXTitleList Request

Field Description Format Variable Name NotesCode character DXCode ICD-9-CM diagnosis code. Left-justified,

with or without embedded decimal.Date 9(8) EffDate YYYYMMDD. Discharge date or applicable


List Size numeric ListSize Enter the desired length of the list returned.

Table J-2: GetShortDXTitleList Response

Field Description Format Variable Name NotesCode Title Array I9LabelListResult

s[]Array of code title data.

Code character code ICD-9-CM diagnosis code. Left-justified, without embedded decimal.

Abbreviated Title character title Abbreviated (24-character maximum) description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is not valid for the submitted effective date, the response is “CODE NOT FOUND FOR DATE”. If the submitted code is a rubric or partial code, the full label will be returned, but the requires_further_qualification flag will be set to “yes”.











K GetShortPXTitleList

This section provides descriptions for the GetShortPXTitleList method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetShortPXTitleList Request• GetShortPXTitleList Response


K.1 GetShortPXTitleList RequestThe following table details the input parameters for the GetShortPXTitleList request.

K.2 GetShortPXTitleList ResponseThe following table details the return parameters for the GetShortPXTitleList response.

Table K-1: GetShortPXTitleList Request

Field Description Format Variable Name NotesCode Character PXCode ICD-9-CM procedure code. Left-justified,



List Size Numeric ListSize Enter the desired length of the list returned.

Table K-2: GetShortPXTitleList Response

Field Description Format Variable Name NotesCode Title Array I9LabelListResult

s[]Array of code title data.

Code Character code ICD-9-CM diagnosis code. Left-justified, without embedded decimal.

Abbreviated Title Character title Abbreviated (24-character maximum) description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is not valid for the submitted effective date, the response is “CODE NOT FOUND FOR DATE”. If the submitted code is a rubric or partial code, the full label will be returned, but the requires_further_qualification flag will be set to “yes”.








L GetShortHCPCSTitle List

This section provides descriptions for the GetShortHCPCSTitleList method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetShortHCPCSTitleList Request• GetShortHCPCSTitleList Response


L.1 GetShortHCPCSTitleList RequestThe following table details the input parameters for the GetShortHCPCSTitleList request.

L.2 GetShortHCPCSTitleList ResponseThe following table details the return parameters for the GetShortHCPCSTitleList response.

Table L-1: GetShortHCPCSTitleList Request

Field Description Format Variable Name NotesCode Character HCPCSCode HCPCS Level I, Level II or modifier. A

modifier title is returned if “099” is prefixed to the required modifier code. Left-justified, five characters required.

Date 9(8) EffDate YYYYMMDD. Discharge date or applicable service date. If no date is supplied, this operation will return the most recent valid label for the code.

List Size Numeric ListSize Enter the desired length of the list returned.

Table L-2: GetShortHCPCSTitleList Response

Field Description Format Variable Name NotesCode Title Array HCPCSLabelList

Results[]Array of code title data.

Code Character code HCPCS Level I, Level II or modifier. Modifier titles are returned if “099” is prefixed to the required modifier code.

Abbreviated Title Character title Abbreviated (24-character maximum) description for the supplied code. If the code is invalid, response is “CODE NOT FOUND”. If the code is invalid for the submitted service date, response is “CODE NOT FOUND FOR DATE”.


M GetAPCTitle

This section provides descriptions for the GetAPCTitle method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetAPCTitle Request• GetAPCTitle Response


M.1 GetAPCTitle RequestThe following table details the input parameters for the GetAPCTitle request.

M.2 GetAPCTitle ResponseThe following table details the return parameters for the GetAPCTitle response.

Table M-1: GetAPCTitle Request

Field Description Format Variable Name NotesAPC string APC APC or HHRG code. Leading zeroes are

not required.Grouper Type string grouper_type Grouper or Reader type can be submitted

as follows:71: CMS (Medicare APC)57: (Medicare ASC)62: (Medicare HHRG)63: (TRICARE APC)

Grouper Version string grouper_version For Medicare APC and ASC, Grouper version numbers conform to the following convention:

10: CY2010 (1/1/10 – 12/31/2010), for example:

For HHRG, Reader version number is “01.”

For TRICARE APC, version number is “01.”

The year of the current date is the default.

Table M-2: GetAPCTitle Response

Field Description Format Variable Name NotesAPC Title string title Abbreviated (40-character maximum)

description for the supplied APC or HHRG. If the code is invalid, or not valid for the specified Grouper/Reader type or version, the response is “LABEL NOT FOUND.”

APC Payment Status Indicator

string payment_status_indicator

Payment Status Indicator for the APC under the submitted Grouper version.


N GetAPGTitle

This section provides descriptions for the GetAPGTitle method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetAPGTitle Request• GetAPGTitle Response


N.1 GetAPGTitle RequestThe following table details the input parameters for the GetAPGTitle request.

N.2 GetAPGTitle ResponseThe following table details the return parameters for the GetAPGTitle response.

Table N-1: GetAPGTitle Request

Field Description Format Variable Name NotesAPG Numeric APG APG code. Leading zeroes are not

required.Grouper Type string grouper_type Grouper type can be submitted as follows:

61: New York MedicaidGrouper Version string grouper_version For Grouper Type 61 (New York Medicaid

APG): 31: Version 3.1

Table N-2: GetAPGTitle Response

Field Description Format Variable Name NotesAPG Title string title Abbreviated (40-character maximum)

description for the supplied APG. If the code is invalid, or not valid for the specified Grouper type or version, the response is “LABEL NOT FOUND”.


O GetRUGTitle

This section provides descriptions for the GetRUGTitle method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetRUGTitle Request• GetRUGTitle Response


O.1 GetRUGTitle RequestThe following table details the input parameters for the GetRUGTitle request.

O.2 GetRUGTitle ResponseThe following table details the return parameters for the GetRUGTitle response.

Table O-1: GetRUGTitle Request

Field Description Format Variable Name NotesAPG Numeric RUG APG code. Leading zeroes are not

required.Grouper Type string grouper_type Grouper/Reader type can be submitted as

a number.22: SNF (RUG Reader)23: SNF (SNF Reader)

Grouper/Reader Version

string grouper_version For Grouper/Reader Type 22 (RUG Reader): 01: Version 1.0

Table O-2: GetRUGTitle Response

Field Description Format Variable Name NotesRUG Title string GetRUGTitle

ResultAbbreviated (40-character maximum) description for the supplied RUG. If the code is invalid, or not valid for the specified Grouper/Reader type or version, the response is “LABEL NOT FOUND”.


P GetHACTitle

This section provides descriptions for the GetHACTitle method. For this method, view sample XML requests and responses within the appropriate *.asmx files, in SOAP, HTTP GET, and HTTP POST formats.


This appendix contains the following sections:• GetHACTitle Request• GetHACTitle Response


P.1 GetHACTitle RequestThe following table details the input parameters for the GetHACTitle request.

P.2 GetHACTitle ResponseThe following table details the return parameters for the GetHACTitle response.

Table P-1: GetHACTitle Request

Field Description Format Variable Name NotesHAC Numeric HAC Number returned by the EASYGroup™/

Date-Sensitive Code Editor identifying the hospital-acquired condition (HAC).

HAC Set string HAC_Set 01 = Medicare HACs03 = TRICARE HACs09 = APS-DRGs® HACsGA = Georgia Medicaid HACsIN = Indiana Medicaid HCACsKY = Kentucky Medicaid HCACsMI = Michigan Medicaid HACsNC = North Carolina Medicaid HCACsNE = Nebraska Medicaid HACsNJ = New Jersey Medicaid HACsNM = New Mexico Medicaid HACsNY = New York Medicaid HACsTX = Texas Medicaid HACsVA = Virginia Medicaid HACsWA = Washington Medicaid HCACsWAHCA = Washington Health Care

Authority HACsWI = Wisconsin Medicaid HACsMCD = Medicaid HCACs

Discharge Date 9(8) Discharge_Date YYYYMMDD. If no date is supplied, this method will return the most recent valid label.

Note: HACs are valid starting October 1, 2008 (Medicare and APS-DRGs®) and October 1, 2009 (TRICARE).

Table P-2: GetHACTitle Response

Field Description Format Variable Name NotesHAC Title string title 100-character description for the requested

hospital-acquired condition.


Q FileReplace Structures

This chapter contains the following sections:• ReplaceFiles• Query• Search


Q.1 ReplaceFiles

Q.2 Query

Q.3 Search

Table Q-1: ReplaceFiles Layout

Field Description Format Variable Name NotesPath The directory name of where the file is

located.Force Direction (true/false) to the Optimizer

(IOCNTRL) to not wait for all files to not be in use/open (Active = 0).

Table Q-2: Query Layout

Field Description Format Variable Name NotesPath The name of the directory where the file is

located.Name The file name.Active Number of clients currently using the given

file name.

Table Q-3: Search Layout

Field Description Format Variable Name NotesPath The directory where the file is located.Name The file name.Current Equals true if the file currently exists on the

system.New Equals true if the file currently exists in the

New directory.


R GetCodeLabelArray

This section provides descriptions for the GetCodeLabelArray method. This method is used for multiple code description return.


This appendix contains the following sections:• GetCodeLabelArray Request• GetCodeLabelArray Response


R.1 GetCodeLabelArray RequestThe following table details the input parameters for the GetCodeLabelArray request. The GetCodeLabelArray request is an array and can occur up to 999 times.

R.2 GetCodeLabelArray ResponseThe following table details the return parameters for the GetCodeLabelArray response. The GetCodeLabelArray response is an array and can occur up to 999 times.

Table R-1: GetCodeLabelArray Request

Field Description Format Variable Name NotesLabel Code Type X(1) LabelCodeType Type of label being retrieved.

C = CPT®-4 Procedure CodeD = ICD-9 Diagnosis CodeP = ICD-9 Procedure CodeK = ICD-10 Diagnosis CodeL = ICD-10 Procedure CodeH = HCPCS Procedure Code

Code X(10) Code Code request for label outputEffective Date 9(8) Date YYYYMMDD. Effective date for

code label being retrieved.Label Length X(1) LabelLength Length of label being retrieved.

S = ShortM = MediumL = Long

Table R-2: GetCodeLabelArray Response

Field Description Format Variable Name NotesLabel Code Type X(1) LabelCodeType Type of label being retrieved.

C = CPT®-4 Procedure CodeD = ICD-9 Diagnosis CodeP = ICD-9 Procedure CodeK = ICD-10 Diagnosis CodeL = ICD-10 Procedure CodeH = HCPCS Procedure Code

Code X(10) Code Code request for label output.Title X(255) TitleRequires Further Qualification

Character requires_further_qualification

True or False. Applies to code type D or K, only.

Exempt From POA Reporting

Character exempt_from_poa_reporting

Applies to code type D or K, only.


S Custom Label Files

This section provides an overview of the Custom Label Files that can be created within the Label Web Service. This appendix contains the following sections:

• Overview• How to Create Custom File Layouts

- ICD-9-CM Diagnosis File Layout- ICD-9-CM Procedures File Layout- ICD-10-CM Diagnosis File Layout- ICD-10-PCS Procedures File Layout- HCPCS/CPT® File Layout

• File Names and Location


S.1 OverviewThe Labels Web Service supports the creation of an user-defined labels file. Clients have the ability to define their own custom labels, so that they can create labels that will coincide with their user-defined reports and periphery systems. This allows clients the ability to be able to update their label descriptions independently of Optum label descriptions and maintain their content. Clients are also able to use one set of descriptions for all three types of descriptions (short, medium, and long).

NoteIf the short, medium, or long label descriptions are more then 255 characters the system will only display the first 255 characters.

When custom label files are present, the code labels in these files are displayed in place of the code labels distributed with the Labels Web Service, by default. If custom file layouts are not present, the Labels Web Service will use the standard, supplied labels. Updates do not overwrite custom label files.

S.2 How to Create Custom File LayoutsThe tables below detail the file layouts for each file. The custom label files should be created by an experienced Database Administrator.The following guidelines apply to all custom label files:

1. No decimal points in any code field. Example: The DX code 46.71 must be stored as 4671.

2. All code fields must be left justified.3. Must be sorted based on the Code/Sequence field. The code performs

a binary search on the Key/Sequence number. If the file is not sorted correctly, the search will fail.

4. Duplicate DX codes are not allowed in the file. If duplicates are found, the program will choose based on the pattern from the binary search.

5. Must be fixed length.


S.2.1 ICD-9-CM Diagnosis File Layout

S.2.2 ICD-9-CM Procedures File Layout

Table S-1: i9dxuser.dat File Layout

Field Description Format NotesICD-9-CM Code X(9) ICD-9-CM diagnosis. Left-justified;

blank-filled. No decimal point.Code Sequence Number 9(2) Sequence number (01, 02, 03...)

used when the same ICD-9-CM code is included multiple times. Sorted in descending order related to Starting Date/Ending Date.

Starting Date 9(8) 00000000 = Code never valid.YYYYMMDD = Effective date for this code record.

Ending Date 9(8) 00000000 = Code never valid or data for this code record is still in effect.YYYYMMDD = Termination date for this code record.

Short Label X(255) ICD-9-CM short DX code description.

Medium Label X(255) ICD-9-CM medium DX code description.

Large Label X(255) ICD-9-CM long DX code description.

Table S-2: i9puser.dat File Layout

Field Description Format NotesICD-9-CM Code X(9) ICD-9-CM procedure code. Left-

justified; blank-filled. No decimal point.

Code Sequence Number 9(2) Sequence number (01, 02, 03...) used when the same ICD-9-CM code is included multiple times. Sorted in descending order related to Starting Date/Ending Date.

Starting Date 9(8) 00000000 = Code never valid.YYYYMMDD = Effective date for

this code record.Ending Date 9(8) 00000000 = Code never valid or

data for this code record is still in effect.

YYYYMMDD = Termination date for this code record.

Short Label X(255) ICD-9-CM short procedure code description.


S.2.3 ICD-10-CM Diagnosis File Layout

S.2.4 ICD-10-PCS Procedures File Layout

Medium Label X(255) ICD-9-CM medium procedure code description.

Large Label X(255) ICD-9-CM long procedure code description.

Table S-3: i10dxuser.dat File Layout

Field Description Format NotesICD-10-CM Code X(9) ICD-10-CM diagnosis. Left-justified;

blank-filled. No decimal point.Code Sequence Number 9(2) Sequence number (01, 02, 03...)

used when the same ICD-9-CM code is included multiple times. Sorted in descending order related to Starting Date/Ending Date.





Short Label X(255) ICD-10-CM short DX code description.

Medium Label X(255) ICD-10-CM medium DX code description.

Large Label X(255) ICD-10-CM long DX code description.


Field Description Format NotesICD-10-CM Code X(9) ICD-10-PCS procedure. Left-

justified; blank-filled. No decimal point.

Code Sequence Number 9(2) Sequence number (01, 02, 03...) used when the same ICD-10-PCS code is included multiple times. Sorted in descending order related to Starting Date/Ending Date.


Field Description Format Notes


S.2.5 HCPCS/CPT® File Layout





Short Label X(255) ICD-10-PCS short procedure code description.

Medium Label X(255) ICD-10-PCS medium procedure code description.

Large Label X(255) ICD-10-PCS long procedure code description.

Table S-5: hcuser.dat File Layout

Field Description Format NotesType X(1) H = HCPCS

C = CPT®Code X(9) HCPCS/CPT® code. Left-justified;

blank-filled. No decimals.Code Sequence Number 9(2) Sequence number (01, 02, 03....)

used when the same HCPCS/CPT® code is included multiple times. Sorted in descending order related to Starting Date/Ending Date.





Short Label X(255) Short HCPCS/CPT® code description.

Medium Label X(255) Medium HCPCS/CPT® code description.

Large Label X(255) Long HCPCS/CPT® code description.


Field Description Format Notes


S.3 File Names and LocationThere could be up to five custom files loaded to the server. The administrator must use the following naming conventions for those files.

On the server, the data files must be loaded onto the web application server. All custom label files must be loaded to the following location:

\Inetpub\wwwroot\HSS\DataTo find the default location check the HssSetup.ini file in the Windows/WINNT folder:

Figure S-1. Default Location in HssSetup.ini File

After all the files are copied perform an IIS reset.

Table S-6: Custom File Naming Conventions

File Name Descriptioni9dxuser.dat ICD-9-CM Diagnosisi9puser.dat ICD-9-CM Procedureshcuser.dat HCPCS/CPT®i10dxuser.dat ICD-10-CM Diagnosisi10puser.dat ICD-10-PCS Procedures


List of TablesTechnical Support Options 7

GetShortDXTitle and GetLongDXTitle Requests 43

GetShortDXTitle Response 43

GetLongDXTitle Response 44

GetShortPXTitle and GetLongPXTitle Requests 46

GetShortPXTitle Response 46

GetLongPXTitle Response 47

GetShortI10DXTitle, GetMediumI10DXTitle and GetLongDXI10Title Requests 49

GetShortI10DXTitle Response 49

GetMediumI10DXTitle Response 50

GetLongI10DXTitle Response 50

GetShortI10PXTitle, GetMediumI10PXTitle, and GetLongI10PXTitle Requests 53

GetShortI10PXTitle Response 53

GetMediumI10PXTitle Response 53

GetLongI10PXTitle Response 54

GetShortHCPCSTitle and GetLongHCPCSTitle Requests 56

GetShortHCPCSTitle Response 56

GetLongHCPCSTitle Response 56

GetDRGTitle Request 58

GetDRGTitle Response 58

GetMDCTitle Request 61

GetMDCTitle Response 61


GetMDCNumber Request 63

GetMDCNumber Response 63

GetDXCodesRange Response 65

GetPXCodesRange Response 65

GetHCPCSCodesRange Response 65

GetShortDXTitleList Request 67

GetShortDXTitleList Response 67

GetShortPXTitleList Request 69

GetShortPXTitleList Response 69

GetShortHCPCSTitleList Request 71

GetShortHCPCSTitleList Response 71

GetAPCTitle Request 73

GetAPCTitle Response 73

GetAPGTitle Request 75

GetAPGTitle Response 75

GetRUGTitle Request 77

GetRUGTitle Response 77

GetHACTitle Request 79

GetHACTitle Response 79

ReplaceFiles Layout 81

Query Layout 81

Search Layout 81

GetCodeLabelArray Request 83

GetCodeLabelArray Response 83


i9dxuser.dat File Layout 86

i9puser.dat File Layout 86

i10dxuser.dat File Layout 87

i10puser.dat File Layout 87

hcuser.dat File Layout 88

Custom File Naming Conventions 89


IndexAAnalysis DRG 84CContact Optum 6Contact Us 6

Client Services 6Corporate Address 6

FFileReplace Structures 80GGuide Overview 6

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