lookup_code
Look up medical codes (CPT, HCPCS, ICD-10, NDC) to get descriptions, RVU values, and Medicare coverage policies for billing and compliance verification.
Instructions
Look up a medical code (CPT, HCPCS, ICD-10, or NDC) and get coverage information. Returns code details, descriptions, RVU values, and related Medicare policies. Use this to understand what a code means and whether it's covered.
Examples:
lookup_code("76942") - ultrasound guidance
lookup_code("J0585") - Botox injection
lookup_code("M54.5") - low back pain diagnosis
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| code | Yes | The medical code to look up (e.g., 76942, J0585, M54.5) | |
| code_system | No | Code system hint - auto-detected if not provided | |
| jurisdiction | No | MAC jurisdiction code to filter policies (e.g., JM, JH) | |
| include | No | Additional data: 'rvu', 'policies', or 'rvu,policies' | |
| fuzzy | No | Enable fuzzy matching for typos/partial codes |