interpretation_requirement
Submitted arguments
{
"code": "97162"
}Native result and verdict
{
"does_not_license": {
"reading": "NO READING IS ATTACHED. These fields carry no interpretation, and this world does not supply one unasked. To obtain a reading, and to find out whether what you are about to write is supported, call judgement_check with receipt \"r303\" and the claims you intend to make. A claim written without checking it is a claim this world did not license.\n\nIf you can write your claim as an expression over the figures above, for example {\"op\": \"<=\", \"left\": \"articles_naming_this_code\", \"right\": 12, \"scope\": \"marginal\"}, call claim_check with the same receipt instead. It decides by entailment over those figures and never reads your sentence, so it answers the same way in any language. The two checks are alternatives and neither falls back to the other."
},
"kind": "served",
"licence": {
"coverage_database": "Contains information from the CMS Medicare Coverage Database.",
"cpt": "CPT is copyright the American Medical Association. Served under a distribution licence.",
"linkback": "https://hammer.ai/coverage-intelligence",
"terms": "https://hammer.ai/terms"
},
"payload": {
"articles_naming_this_code": 10,
"articles_stating_a_requirement": 0,
"code": "97162",
"coverage_frontier": {
"codes_searched": [
"0002M",
"0003M",
"81517",
"0014M",
"91200",
"76981",
"76982",
"76983",
"80076",
"0689T",
"0690T",
"76705",
"99473",
"99474",
"93784",
"93786",
"93788",
"93790",
"99091",
"99453",
"99454",
"99457",
"99458",
"3074F",
"3075F",
"3077F",
"3078F",
"3079F",
"3080F",
"99213",
"99214",
"99215",
"99495",
"99496",
"99490",
"99491",
"99487",
"93306",
"93307",
"93308",
"93000",
"93010",
"83880",
"93797",
"93798",
"G0422",
"G0423",
"80061",
"83718",
"80048",
"80053",
"82043",
"84443",
"83036",
"93880",
"93975",
"76770",
"27235",
"27236",
"27244",
"27245",
"27125",
"27130",
"27447",
"99283",
"99284",
"99285",
"73502",
"73521",
"72131",
"70450",
"22633",
"22612",
"63047",
"63030",
"63005",
"22551",
"97110",
"97112",
"97116",
"97140",
"97530",
"97535",
"97750",
"97161",
"97162",
"97163",
"97164",
"97012",
"97014",
"G0283",
"97032",
"97035",
"98975",
"98976",
"98977",
"98978",
"98979",
"98980",
"98981",
"98984",
"98985",
"0320U",
"0319U",
"0540U",
"81479",
"50200",
"50370",
"50360",
"50365",
"90935",
"90937",
"90945",
"90960",
"90961"
],
"commercial_payer_policy_held": false,
"contractors_publishing_a_matrix": [
"First Coast Service Options, Inc.",
"Novitas Solutions, Inc."
],
"corpus": "Medicare Local Coverage Articles",
"scope": "Medicare Local Coverage Articles only. Commercial payer medical policy is NOT in this extract, so a code with no row here is not a code no payer restricts.",
"source": "CMS Medicare Coverage Database Articles export, vintage 2026-08-20",
"source_terms": "CMS cleared this use on 2026-08-22 on condition the source is linked back and the service is not paid. Every record carries source_url for that reason.",
"this_code_was_searched": true,
"vintage": "2026-08-20"
},
"how_to_read_this": "Each record is one contractor's article. A requirement binds that contractor and no other, and the IDTF matrix governs Independent Diagnostic Testing Facilities rather than physician offices in general. A record with no `credentialing` names the code without stating who may furnish it.",
"receipt": "r303",
"requirements": [
{
"article_id": "52775",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Noridian Healthcare Solutions, LLC"
],
"effective_date": "2020-04-28",
"end_date": "2025-10-02",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52775",
"status": "R",
"title": "Billing and Coding: Medical Necessity of Therapy Services"
},
{
"article_id": "53046",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Noridian Healthcare Solutions, LLC"
],
"effective_date": "2024-01-01",
"end_date": "2026-03-05",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53046",
"status": "R",
"title": "Billing and Coding: Wound Care and Debridement - Provided by a Therapist, Physician, NPP, or as Incident-to Services"
},
{
"article_id": "53058",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Palmetto GBA"
],
"effective_date": "2026-01-01",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53058",
"status": "A",
"title": "Billing and Coding: Home Health Physical Therapy"
},
{
"article_id": "53065",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Palmetto GBA"
],
"effective_date": "2026-01-01",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53065",
"status": "A",
"title": "Billing and Coding: Outpatient Physical Therapy"
},
{
"article_id": "53296",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Noridian Healthcare Solutions, LLC"
],
"effective_date": "2026-03-05",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53296",
"status": "A",
"title": "Billing and Coding: Wound Care & Debridement – Provided by a Therapist, Physician, NPP or as Incident-to Services"
},
{
"article_id": "53304",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Noridian Healthcare Solutions, LLC"
],
"effective_date": "2025-10-02",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53304",
"status": "A",
"title": "Billing and Coding: Medical Necessity of Therapy Services"
},
{
"article_id": "56566",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Wellpoint Federal"
],
"effective_date": "2026-04-01",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56566",
"status": "A",
"title": "Billing and Coding: Outpatient Physical and Occupational Therapy Services"
},
{
"article_id": "57021",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"Palmetto GBA"
],
"effective_date": "2024-01-01",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57021",
"status": "A",
"title": "Billing and Coding: Cervical Disc Replacement"
},
{
"article_id": "57067",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"CGS Administrators, LLC"
],
"effective_date": "2026-06-04",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57067",
"status": "A",
"title": "Billing and Coding: Outpatient Physical and Occupational Therapy Services"
},
{
"article_id": "57311",
"binds": "This article's own contractor only. It is not a national rule.",
"contractors": [
"CGS Administrators, LLC"
],
"effective_date": "2026-08-06",
"enrolment_type": "not stated in this article's title, so this world does not know which enrolment type it governs",
"source_url": "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57311",
"status": "A",
"title": "Billing and Coding: Physical Therapy - Home Health"
}
],
"world_version": "hammer-coverage-intelligence:2026-10-01+2"
},
"receipt": "r303",
"session": "c52be156e5ecaef5003ce542964e306f",
"tool": "interpretation_requirement",
"world": {
"build": 2,
"description": "What payers publish that they pay, code by code, and what may be said with it.",
"name": "hammer-coverage-intelligence",
"vintage": "2026-10-01"
}
}Permanent saved result
Read this evidence receipt
claim_check
judgement_check