List Candidate Modifiers

curl --request GET \
  --url https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers \
  --header 'API-KEY: <api-key>' \
  --header 'TENANT: <tenant>'

import requests

url = "https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers"

headers = {
    "TENANT": "<tenant>",
    "API-KEY": "<api-key>"
}

response = requests.get(url, headers=headers)

print(response.text)

const options = {method: 'GET', headers: {TENANT: '<tenant>', 'API-KEY': '<api-key>'}};

fetch('https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers', options)
  .then(res => res.json())
  .then(res => console.log(res))
  .catch(err => console.error(err));

<?php

$curl = curl_init();

curl_setopt_array($curl, [
  CURLOPT_URL => "https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers",
  CURLOPT_RETURNTRANSFER => true,
  CURLOPT_ENCODING => "",
  CURLOPT_MAXREDIRS => 10,
  CURLOPT_TIMEOUT => 30,
  CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
  CURLOPT_CUSTOMREQUEST => "GET",
  CURLOPT_HTTPHEADER => [
    "API-KEY: <api-key>",
    "TENANT: <tenant>"
  ],
]);

$response = curl_exec($curl);
$err = curl_error($curl);

curl_close($curl);

if ($err) {
  echo "cURL Error #:" . $err;
} else {
  echo $response;
}

package main

import (
	"fmt"
	"net/http"
	"io"
)

func main() {

	url := "https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers"

	req, _ := http.NewRequest("GET", url, nil)

	req.Header.Add("TENANT", "<tenant>")
	req.Header.Add("API-KEY", "<api-key>")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(string(body))

}

HttpResponse<String> response = Unirest.get("https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers")
  .header("TENANT", "<tenant>")
  .header("API-KEY", "<api-key>")
  .asString();

require 'uri'
require 'net/http'

url = URI("https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Get.new(url)
request["TENANT"] = '<tenant>'
request["API-KEY"] = '<api-key>'

response = http.request(request)
puts response.read_body

[
  {
    "code": "<string>",
    "label": "<string>",
    "crosswalked": true
  }
]

{
  "detail": [
    {
      "loc": [
        "<string>"
      ],
      "msg": "<string>",
      "type": "<string>",
      "input": "<unknown>",
      "ctx": {}
    }
  ]
}

Medical Codes

List Candidate Modifiers

Candidate (NOT eligible) modifiers for a CPT/HCPCS code.

Narrows the Super Bill editor’s modifier picker to the union of:

PROCEDURE modifiers the AMA CPT Modifier Crosswalk associates with the line’s code (cpt_modifier -> modifier for the label), and
every INSURANCE modifier, regardless of code.

The union exists because the crosswalk only catalogs procedure modifiers — facts about how a procedure was performed (26 professional component, 50 bilateral). INSURANCE modifiers (the CMS ABN family: GA/GX/GY/GZ) instead describe whether the PAYER covers the line, which turns on the patient’s plan rather than the procedure — so no code->modifier crosswalk can express them, and their absence from it is guaranteed rather than evidence of invalidity. Crosswalk-only candidates hid GY from chiropractic billers, who need it on essentially every line that isn’t 98940/98941/98942.

Final correctness still depends on payer, documentation, POS, provider type, the other claim lines, and encounter context — so these are candidates, and the picker keeps its free-type escape.

An unknown code returns the insurance modifiers (not []): they are code-independent, and free-typed lines carrying codes absent from the licensed cpt catalog (e.g. J-codes) are exactly where a biller reaches for GY.

Each row carries crosswalked — whether the crosswalk pairs it with THIS code, as opposed to being present only because it is an insurance modifier. The picker warns about an off-list modifier only for a code the crosswalk actually has rows for; because insurance modifiers make the list never-empty, “no rows for this code” is no longer an empty list and needs this flag to stay detectable. It is derived per request, not the modifier’s stored type.

GET

medical-codes

cpt

{code}

candidate-modifiers

List Candidate Modifiers

curl --request GET \
  --url https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers \
  --header 'API-KEY: <api-key>' \
  --header 'TENANT: <tenant>'

import requests

url = "https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers"

headers = {
    "TENANT": "<tenant>",
    "API-KEY": "<api-key>"
}

response = requests.get(url, headers=headers)

print(response.text)

const options = {method: 'GET', headers: {TENANT: '<tenant>', 'API-KEY': '<api-key>'}};

fetch('https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers', options)
  .then(res => res.json())
  .then(res => console.log(res))
  .catch(err => console.error(err));

<?php

$curl = curl_init();

curl_setopt_array($curl, [
  CURLOPT_URL => "https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers",
  CURLOPT_RETURNTRANSFER => true,
  CURLOPT_ENCODING => "",
  CURLOPT_MAXREDIRS => 10,
  CURLOPT_TIMEOUT => 30,
  CURLOPT_HTTP_VERSION => CURL_HTTP_VERSION_1_1,
  CURLOPT_CUSTOMREQUEST => "GET",
  CURLOPT_HTTPHEADER => [
    "API-KEY: <api-key>",
    "TENANT: <tenant>"
  ],
]);

$response = curl_exec($curl);
$err = curl_error($curl);

curl_close($curl);

if ($err) {
  echo "cURL Error #:" . $err;
} else {
  echo $response;
}

package main

import (
	"fmt"
	"net/http"
	"io"
)

func main() {

	url := "https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers"

	req, _ := http.NewRequest("GET", url, nil)

	req.Header.Add("TENANT", "<tenant>")
	req.Header.Add("API-KEY", "<api-key>")

	res, _ := http.DefaultClient.Do(req)

	defer res.Body.Close()
	body, _ := io.ReadAll(res.Body)

	fmt.Println(string(body))

}

HttpResponse<String> response = Unirest.get("https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers")
  .header("TENANT", "<tenant>")
  .header("API-KEY", "<api-key>")
  .asString();

require 'uri'
require 'net/http'

url = URI("https://api.decodahealth.com/medical-codes/cpt/{code}/candidate-modifiers")

http = Net::HTTP.new(url.host, url.port)
http.use_ssl = true

request = Net::HTTP::Get.new(url)
request["TENANT"] = '<tenant>'
request["API-KEY"] = '<api-key>'

response = http.request(request)
puts response.read_body

[
  {
    "code": "<string>",
    "label": "<string>",
    "crosswalked": true
  }
]

{
  "detail": [
    {
      "loc": [
        "<string>"
      ],
      "msg": "<string>",
      "type": "<string>",
      "input": "<unknown>",
      "ctx": {}
    }
  ]
}

Headers

TENANT

string

required

The tenant you are making this request on behalf of

API-KEY

string

required

Your api key

Path Parameters

code

string

required

Response

Successful Response

code

string

required

label

string

required

crosswalked

boolean

required

Get Icd Ten Code List Places Of Service

Getting Started

API Guides

Patient Management

Billing & Payments

Catalog & Inventory

Growth

Clinical & Scheduling

Platform

List Candidate Modifiers

Headers

Path Parameters

Response