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Glama

DenialPath

by io.github.maxbeech

Look up an MUE unit limit for one code

get_mue
Read-onlyIdempotent

Look up the medically unlikely edit (MUE) unit limit for a single CPT/HCPCS code. status is found or no_data; no_data means we hold no MUE value for this code in our dataset, not that CMS publishes none. When found, the returned limit.mai (adjudication indicator: "1" line edit - denies the excess units on the line; "2" date-of-service absolute - never payable above the limit on that date, not even on appeal; "3" date-of-service clinical - may be allowed above the limit with supporting documentation) governs what a biller can do above the limit, explained in limit.maiMeaning. Free, no API key needed.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
codeYesCPT/HCPCS code, e.g. "36415".

Schema Changelog

Changes observed during successful MCP inspections. Dates show when Glama detected each change.

  1. First observed

TDQS

A4.4/5.0
Behavior5/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already declare readOnlyHint, idempotentHint, and destructiveHint. The description adds substantial behavioral context: exact status values ('found' vs 'no_data') with interpretation, the three MAI adjudication indicators with billing consequences (including 'not even on appeal' and 'may be allowed above the limit with supporting documentation'), and access requirements. This goes well beyond annotation coverage.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness4/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Four sentences, each conveying distinct, valuable information: core purpose, status semantics, MAI meanings, and free access. It is dense but not wordy, and front-loaded with the main purpose. The MAI explanation is lengthy but essential for interpretation.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness5/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

With no output schema, the description carries the full burden of explaining return behavior. It covers the status field, the meaning of no_data, the critical limit.mai field and its three variants, and the free access. For a single-parameter lookup, this is highly complete.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema covers the only parameter 'code' with a description and example ('CPT/HCPCS code, e.g. "36415"'). The description reiterates 'single CPT/HCPCS code' but adds no new format, constraints, or usage details beyond the schema, so baseline 3 applies.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description opens with a specific verb and resource: 'Look up the medically unlikely edit (MUE) unit limit for a single CPT/HCPCS code.' It clearly distinguishes from sibling tools like get_ncci_edits by naming MUE rather than NCCI edits and emphasizing single-code scope.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Provides clear context for when to use the tool: for MUE unit lookup on a single code, and notes it is free with no API key. It does not explicitly name alternatives or state when not to use, but the purpose is unambiguous and the sibling set makes the distinction obvious.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

All DenialPath toolsInspect
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TDQS

A4.2/5.0
Disambiguation5/5

Each tool targets a distinct function: claim checking, appeal drafting, denial explanation, MUE lookup, NCCI edits lookup, and timely filing. There is no overlap in purpose, and the descriptions make the boundaries clear.

Naming Consistency5/5

All tool names follow a consistent verb_noun pattern (check_claim, draft_appeal, explain_denial, get_mue, get_ncci_edits, get_timely_filing). The verbs are specific and the nouns are meaningful, creating a predictable and readable naming scheme.

Tool Count5/5

Six tools is well within the ideal range for a focused server. The count feels appropriate for the denial management domain, with each tool earning its place and no redundancy.

Completeness5/5

The toolset covers the full denial lifecycle: pre-claim checking (check_claim), denial explanation (explain_denial), appeal drafting (draft_appeal), and supporting lookups (get_mue, get_ncci_edits, get_timely_filing). No obvious gaps exist for the stated purpose.

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