---
title: "Code Inpatient"
method: POST
path: "/api/v1/inpatient/code"
tags: ["inpatient"]
---

# Code Inpatient

`POST /api/v1/inpatient/code`

## Request

- Base URL: `https://api.accurecord.io` (the document declares no server; this is the origin it was published from)
- URL: `https://api.accurecord.io/api/v1/inpatient/code`
- Auth: none declared

Code the ICD-10-PCS procedures documented in an inpatient chart.

Stage 1 (LLM) extracts procedure mentions in the chart's words; Stage 2 walks CMS's index
and code tables deterministically; Stage 3 (LLM) chooses ONLY among legal values when the
chart's words do not settle a character; Stage 4 verifies against the discharge-date
edition and the PCS guidelines. **Neither LLM call can produce a code** — codes come
from the tables. Anything the chart does not settle is returned under ``needs_review``
with the legal menu, never guessed.

Supply ``principal_dx`` (+ ``secondary_dx``, all with POA) and the encounter fields to
also receive the MS-DRG and a principal procedure chosen by the CMS grouper; without them
``principal_procedure.basis`` is ``first_definitive_proposal``.

**Requires Pro or Enterprise tier, an executed BAA, and PHI activation.**

## Headers

- `x-api-key` string, nullable

## Request body

- InpatientCodeRequest
  - `chart_text` string, required: Inpatient chart. ⚠ PHI.
  - `encounter` EncounterIn, required
    - `admission_date` string, date, nullable
    - `discharge_date` string, date, required: Selects the PCS edition and the grouper version (Oct–Mar / Apr–Sep).
    - `age_years` integer, nullable
    - `sex` string, nullable: M, F or U
    - `discharge_status` integer, nullable: UB-04 patient discharge status, e.g. 1 home, 20 expired.
    - `poa_exempt_hospital` boolean, nullable: Whether the hospital is exempt from POA reporting.
    - `age_days_admit` integer, nullable
    - `age_days_discharge` integer, nullable
  - `principal_dx` DiagnosisIn
    - `code` string, required: ICD-10-CM, dots optional
    - `poa` string, nullable: Present-on-admission: Y, N, U, W, or 1 (exempt). REQUIRED — a missing POA is refused with drg_poa_missing, never defaulted.
  - `secondary_dx` DiagnosisIn[]
    - `code` string, required: ICD-10-CM, dots optional
    - `poa` string, nullable: Present-on-admission: Y, N, U, W, or 1 (exempt). REQUIRED — a missing POA is refused with drg_poa_missing, never defaulted.

## Response `200`

Successful Response

- object

## Other responses

- `400`: Malformed or out-of-bounds request — a batch over 50 codes, a file over the upload limit, an unparseable identifier, or a surface that is switched off in this environment (the `cpt_*_disabled` gates are 400, not 403). ⚠ Not interchangeable with 422: 400 is raised BY the handler, 422 by request validation.
- `401`: Missing, malformed, revoked or expired credential. Send the key as `X-API-Key` or `Authorization: Bearer`. `detail` is a string, except the MFA challenge on `/auth/login`, which is `{code: 'mfa_required', message}`.
- `403`: Authenticated but not permitted: the tier does not include the feature, the role is insufficient, or the free tier is paused. Gate-specific bodies use the `{code, message}` shape (`tier_required`, `insufficient_role`). ⚠ The free-tier pause is the ONE error in the service that does not use `detail` at all — its body is `{error: 'free_tier_paused', message}` at the top level. ⚠ Preconditions the caller CAN satisfy (no org, no BAA, PHI mode off) are 412, not 403 — see below.
- `404`: Resource, code, or org-scoped record not found. Note that a record belonging to ANOTHER organization is also a 404, never a 403 — existence is not disclosed across tenants.
- `412`: A precondition on the calling principal is unmet and the caller can fix it: no organization linked to the key (`org_required`), no signed BAA (`baa_required`), PHI mode not activated (`phi_not_activated`), reviewer mode off (`review_mode_disabled`), or the session was never second-factored (`mfa_required`). All use the `{code, message}` shape.
- `422`: Request body or query failed validation. FastAPI's own failures are a LIST of `{loc, msg, type}`; semantic refusals raised by the service are an object (the risk-adjustment endpoints use `{status, ...}`).
- `429`: Rate limit exceeded for this key's tier, or the coding surface is at capacity. Read `X-RateLimit-Reset-Minute` for the backoff rather than retrying immediately — an AI coding call is metered as a billable unit and a retry storm is charged.
- `500`: Unhandled server error. The body is `{detail: 'Internal server error', request_id: <id>}` and the same id is on the `X-Request-ID` response header.
- `503`: The coding brain cannot serve this request: the LLM circuit breaker is OPEN after repeated upstream failures, or the CPT surface is switched off / its reference data is unbuilt. ⚠ A breaker that opens MID-request does NOT surface here — the pipeline degrades rather than fails and says so in the 200 body's `degradations[]` (kind `llm_circuit_open`). Read that list: a degraded answer is shaped exactly like a healthy one.

---

[API](https://skmtc.dev/accurecord/apis/icd-10-coding-api.md) · [All operations](https://skmtc.dev/accurecord/apis/icd-10-coding-api/llms.txt) · [OpenAPI document](https://skmtc.dev/accurecord/apis/icd-10-coding-api/revisions/b1e12ce06ba5?raw)