Change Healthcare Clinical Code API

Change Healthcare (Optum) · Health

Health OAuth2 Paid Healthcare Insurance ICD-10 CPT CCI Edits

Change Healthcare (now part of Optum/UnitedHealth) clinical code validation and enrichment API. Supports ICD-10, CPT, HCPCS code validation, CCI edits, Medicare LCD/NCD coverage lookups, and clinical documentation improvement (CDI) suggestions.

Authentication

OAuth2 OAuth2 client credentials — register at developers.changehealthcare.com for sandbox access

Sample Requests

POST Claim code validation

Submit a claim for ICD-10 code validation and CCI edit checks

https://api.changehealthcare.com

Hover any highlighted part to learn what it does

Headers — extra info sent with the request

Content-Type	application/json
Authorization	Bearer {access_token}

Request Body — data you're sending

{
  "diagnoses": [
    {
      "code": "E11.9",
      "codeType": "ABK"
    }
  ],
  "controlNumber": "000000001",
  "claimFilingCode": "11"
}

curl -X POST "https://api.changehealthcare.com" \
  -H "Content-Type: application/json" \
  -H "Authorization: Bearer {access_token}" \
  -H "Content-Type: application/json" \
  -d '{"diagnoses":[{"code":"E11.9","codeType":"ABK"}],"controlNumber":"000000001","claimFilingCode":"11"}'

import requests
headers = {
    "Content-Type": "application/json",
    "Authorization": "Bearer {access_token}"
}
data = {
    "diagnoses": [
        {
            "code": "E11.9",
            "codeType": "ABK"
        }
    ],
    "controlNumber": "000000001",
    "claimFilingCode": "11"
}
response = requests.post(
    "https://api.changehealthcare.com",
    headers=headers,
    json=data,
)
print(response.json())

const url = 'https://api.changehealthcare.com';

const response = await fetch(url, {
  method: 'POST',
  headers: {
    'Content-Type': 'application/json',
    'Authorization': 'Bearer {access_token}'
  },
  headers: { 'Content-Type': 'application/json' },
  body: JSON.stringify({
  "diagnoses": [
    {
      "code": "E11.9",
      "codeType": "ABK"
    }
  ],
  "controlNumber": "000000001",
  "claimFilingCode": "11"
}),
}); 
const data = await response.json();
console.log(data);

package main

import (
	"fmt"
	"io"
	"net/http"
	"bytes"
	"encoding/json"
)

func main() {
	targetURL := "https://api.changehealthcare.com"
	jsonData, _ := json.Marshal({"diagnoses":[{"code":"E11.9","codeType":"ABK"}],"controlNumber":"000000001","claimFilingCode":"11"})
	req, _ := http.NewRequest("POST", targetURL, bytes.NewBuffer(jsonData))
	req.Header.Set("Content-Type", "application/json")
	req.Header.Set("Authorization", "Bearer {access_token}")
	req.Header.Set("Content-Type", "application/json")

	client := &http.Client{}
	resp, _ := client.Do(req)
	defer resp.Body.Close()
	body, _ := io.ReadAll(resp.Body)
	fmt.Println(string(body))
}

require "net/http"
require "json"

uri = URI("https://api.changehealthcare.com")

http = Net::HTTP.new(uri.host, uri.port)
http.use_ssl = uri.scheme == "https"

req = Net::HTTP::Post.new(uri)
req["Content-Type"] = "application/json"
req["Authorization"] = "Bearer {access_token}"
req["Content-Type"] = "application/json"
req.body = "{\"diagnoses\":[{\"code\":\"E11.9\",\"codeType\":\"ABK\"}],\"controlNumber\":\"000000001\",\"claimFilingCode\":\"11\"}"

res = http.request(req)
puts JSON.parse(res.body)

<?php
$url = "https://api.changehealthcare.com";
$opts = ["http" => [
    "method" => "POST",
    "header" => implode("\r\n", [
        "Content-Type: application/json",
        "Authorization: Bearer {access_token}",
        "Content-Type: application/json"
    ]),
    "content" => json_encode({"diagnoses":[{"code":"E11.9","codeType":"ABK"}],"controlNumber":"000000001","claimFilingCode":"11"}),
]];
$ctx = stream_context_create($opts);
$res = file_get_contents($url, false, $ctx);
print_r(json_decode($res, true));

Postman Setup Guide

Get Postman ↗

Register at https://developers.changehealthcare.com/ for a sandbox account
Get an OAuth2 token: POST /apip/auth/v2/token with client_credentials grant
Set Authorization: Bearer {access_token} in Postman
Validate a claim: POST /medicalnetwork/v1/claimvalidation with diagnosis codes
CCI edits check: POST /medicalnetwork/cciedits/v1 with procedure code pairs

What can you build with Change Healthcare Clinical Code API?

Change Healthcare Clinical Code API is a Health API. Developers commonly use health APIs for:

accessing medical reference data and drug information
building patient-facing health tracking apps
integrating with EHR and telemedicine platforms
looking up ICD codes and clinical terminology
powering wellness and fitness applications

OAuth 2.0. OAuth lets your app act on behalf of a user. You redirect them to authorise access, receive a token, then use that token in requests. Best for accessing user-owned data. Change Healthcare Clinical Code API is a paid API — check the provider's pricing page before building a production integration.

New to APIs? Read our beginner's guide · Learn about API keys · What is REST?

Open documentation ↗