{"openapi":"3.1.0","info":{"description":"CRD (Coverage Requirements Discovery) tells a provider, at the moment a DME order is placed, whether prior authorization is required and what documentation the payer will need.","title":"Coverage Requirements Discovery","version":"1.0.0"},"servers":[{"url":"https://sandbox-apigw.optum.com/abm","description":"CRD API"}],"components":{"securitySchemes":{"bearerAuth":{"type":"http","scheme":"bearer","bearerFormat":"JWT","description":"Bearer token issued by the auth token endpoint. Sent as `Authorization: Bearer <token>`. Note: per the OpenAPI spec, the Authorization header is documented via a security scheme rather than as a plain header parameter."}}},"paths":{"/crd/v1":{"post":{"description":"Accepts a CRD FHIR request and returns CRD response","operationId":"executeCrdWorkflow","security":[{"bearerAuth":[]}],"requestBody":{"content":{"application/fhir+json":{"examples":{"CRD Request Example Success":{"description":"CRD Request Example Success","value":"{\n  \"resourceType\": \"Bundle\",\n  \"type\": \"collection\",\n  \"entry\": [\n    {\n      \"fullUrl\": \"urn:payer-org\",\n      \"resource\": {\n        \"resourceType\": \"Organization\",\n        \"name\": \"CCXOPT01\"\n      }\n    },\n    {\n      \"fullUrl\": \"urn:coverage\",\n      \"resource\": {\n        \"resourceType\": \"Coverage\",\n        \"payor\": [\n          {\n            \"reference\": \"urn:payer-org\"\n          }\n        ],\n        \"class\": [\n          {\n            \"type\": {\n              \"coding\": [\n                {\n                  \"system\": \"http://terminology.hl7.org/CodeSystem/coverage-class\",\n                  \"code\": \"class\"\n                }\n              ]\n            },\n            \"name\": \"Line of Business\",\n            \"value\": \"demo\"\n          }\n        ]\n      }\n    },\n    {\n      \"fullUrl\": \"urn:device\",\n      \"resource\": {\n        \"resourceType\": \"Device\",\n        \"type\": {\n          \"coding\": [\n            {\n              \"system\": \"urn:hcpcs_code\",\n              \"code\": \"42831\",\n              \"display\": \"Knee walker\"\n            }\n          ],\n          \"text\": \"Knee walker\"\n        }\n      }\n    },\n    {\n      \"fullUrl\": \"urn:device-request\",\n      \"resource\": {\n        \"resourceType\": \"DeviceRequest\",\n        \"occurrenceDateTime\": \"2026-07-20\",\n        \"codeReference\": {\n          \"reference\": \"urn:device\"\n        },\n        \"extension\": [\n          {\n            \"url\": \"urn:hcpcs-modifier-1\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"urn:modifier-1\",\n                  \"code\": \"RR\",\n                  \"display\": \"Rental\"\n                }\n              ]\n            }\n          },\n          {\n            \"url\": \"urn:hcpcs-modifier-2\",\n            \"valueCodeableConcept\": {\n              \"coding\": [\n                {\n                  \"system\": \"urn:modifier-2\",\n                  \"code\": \"KX\",\n                  \"display\": \"Requirements specified in the medical policy have been met\"\n                }\n              ]\n            }\n          }\n        ],\n        \"insurance\": [\n          {\n            \"reference\": \"urn:coverage\"\n          }\n        ]\n      }\n    }\n  ]\n}"}},"schema":{"type":"string","description":"FHIR Bundle payload, sent as raw JSON text. Server-side, this is received and passed through as a raw JSON string without deserialization into a typed object."}}},"description":"CRD FHIR request payload","required":true},"responses":{"201":{"content":{"application/fhir+json":{"examples":{"CRD Response Example":{"value":{"resourceType":"Parameters","parameter":[{"name":"referenceId","valueString":"545a4424-9c5f-488c-9b72-cbdbb9096843"},{"name":"priorAuthRequired","valueBoolean":true},{"name":"processingContextId","valueString":"b575d6c0-c75d-4143-9022-3fb9a944112b"},{"name":"documentationRequired","valueString":"Y"},{"name":"documentationNeeded","valueString":"both"},{"name":"questionnaire","valueString":"https://integ.ds.interqual.com/caas/fhir/Questionnaire/RM24%7CPROCEDURES%7CISP7501%7CR000"}]}}}}},"description":"CRD response created successfully"}},"summary":"CRD API Endpoint","tags":["CRD API"]}}},"x-readme":{"explorer-enabled":true,"proxy-enabled":true}}