interpretation_requirement

Submitted arguments

{
  "code": "98979"
}

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 \"r111\" and the claims you intend to make. A claim written without checking it is a claim this world did not license.\n\nThis answer declared no figure, so claim_check has nothing to decide an expression against and judgement_check is the check to use. The two 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": {
    "code": "98979",
    "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"
    },
    "not_in_corpus": {
      "searched": true,
      "why_this_is_not_permission": "No policy in this corpus states a furnishing or interpretation requirement for this code. That is not the same as no requirement existing. This corpus holds Medicare Local Coverage Articles and no commercial payer policy at all, and only some Medicare contractors publish the credentialing matrix that would answer. An absence here is a statement about what was searched, never about what is permitted.",
      "would_be_settled_by": [
        {
          "note": "This is where the commercial answer lives. It is NOT medical policy: a coverage bulletin can name a code across hundreds of pages and state nothing about who may furnish it.",
          "register": "the payer's own reimbursement or payment policy",
          "settles": "who may bill and be paid for the service, commercially"
        },
        {
          "note": "Contractors differ. This corpus holds the ones it holds.",
          "register": "the Medicare Coverage Database article for another contractor",
          "settles": "whether a different jurisdiction states a requirement this one does not"
        },
        {
          "register": "the payer's provider manual",
          "settles": "the contract-level supervision rule the code-level policies sit under"
        }
      ]
    },
    "receipt": "r111",
    "world_version": "hammer-coverage-intelligence:2026-10-01+2"
  },
  "receipt": "r111",
  "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