Examples with CCWProcedure gov.cms.bfd.server.war.commons.CCWProcedure used on opensource projects

Example 6 with CCWProcedure

use of gov.cms.bfd.server.war.commons.CCWProcedure in project beneficiary-fhir-data by CMSgov.

the class SNFClaimTransformer method transformClaim.

/**
 * @param claimGroup the CCW {@link SNFClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     SNFClaim}
 */
private static ExplanationOfBenefit transformClaim(SNFClaim claimGroup) {
    ExplanationOfBenefit eob = new ExplanationOfBenefit();
    // Common group level fields between all claim types
    TransformerUtils.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimType.SNF, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_A, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
    TransformerUtils.mapEobWeeklyProcessDate(eob, claimGroup.getWeeklyProcessDate());
    // map eob type codes into FHIR
    TransformerUtils.mapEobType(eob, ClaimType.SNF, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
    // set the provider number which is common among several claim types
    TransformerUtils.setProviderNumber(eob, claimGroup.getProviderNumber());
    // add EOB information to fields that are common between the Inpatient and SNF claim types
    TransformerUtils.addCommonEobInformationInpatientSNF(eob, claimGroup.getAdmissionTypeCd(), claimGroup.getSourceAdmissionCd(), claimGroup.getNoncoveredStayFromDate(), claimGroup.getNoncoveredStayThroughDate(), claimGroup.getCoveredCareThroughDate(), claimGroup.getMedicareBenefitsExhaustedDate(), claimGroup.getDiagnosisRelatedGroupCd());
    if (claimGroup.getPatientStatusCd().isPresent()) {
        TransformerUtils.addInformationWithCode(eob, CcwCodebookVariable.NCH_PTNT_STUS_IND_CD, CcwCodebookVariable.NCH_PTNT_STUS_IND_CD, claimGroup.getPatientStatusCd().get());
    }
    // Common group level fields between Inpatient, HHA, Hospice and SNF
    TransformerUtils.mapEobCommonGroupInpHHAHospiceSNF(eob, claimGroup.getClaimAdmissionDate(), claimGroup.getBeneficiaryDischargeDate(), Optional.of(claimGroup.getUtilizationDayCount()));
    /*
     * add field values to the benefit balances that are common between the
     * Inpatient and SNF claim types
     */
    TransformerUtils.addCommonGroupInpatientSNF(eob, claimGroup.getCoinsuranceDayCount(), claimGroup.getNonUtilizationDayCount(), claimGroup.getDeductibleAmount(), claimGroup.getPartACoinsuranceLiabilityAmount(), claimGroup.getBloodPintsFurnishedQty(), claimGroup.getNoncoveredCharge(), claimGroup.getTotalDeductionAmount(), claimGroup.getClaimPPSCapitalDisproportionateShareAmt(), claimGroup.getClaimPPSCapitalExceptionAmount(), claimGroup.getClaimPPSCapitalFSPAmount(), claimGroup.getClaimPPSCapitalIMEAmount(), claimGroup.getClaimPPSCapitalOutlierAmount(), claimGroup.getClaimPPSOldCapitalHoldHarmlessAmount());
    if (claimGroup.getQualifiedStayFromDate().isPresent() || claimGroup.getQualifiedStayThroughDate().isPresent()) {
        TransformerUtils.validatePeriodDates(claimGroup.getQualifiedStayFromDate(), claimGroup.getQualifiedStayThroughDate());
        SupportingInformationComponent nchQlfydStayInfo = TransformerUtils.addInformation(eob, CcwCodebookVariable.NCH_QLFYD_STAY_FROM_DT);
        Period nchQlfydStayPeriod = new Period();
        if (claimGroup.getQualifiedStayFromDate().isPresent())
            nchQlfydStayPeriod.setStart(TransformerUtils.convertToDate((claimGroup.getQualifiedStayFromDate().get())), TemporalPrecisionEnum.DAY);
        if (claimGroup.getQualifiedStayThroughDate().isPresent())
            nchQlfydStayPeriod.setEnd(TransformerUtils.convertToDate((claimGroup.getQualifiedStayThroughDate().get())), TemporalPrecisionEnum.DAY);
        nchQlfydStayInfo.setTiming(nchQlfydStayPeriod);
    }
    // Common group level fields between Inpatient, Outpatient and SNF
    TransformerUtils.mapEobCommonGroupInpOutSNF(eob, claimGroup.getBloodDeductibleLiabilityAmount(), claimGroup.getOperatingPhysicianNpi(), claimGroup.getOtherPhysicianNpi(), claimGroup.getClaimQueryCode(), claimGroup.getMcoPaidSw());
    // Common group level fields between Inpatient, Outpatient Hospice, HHA and SNF
    TransformerUtils.mapEobCommonGroupInpOutHHAHospiceSNF(eob, claimGroup.getOrganizationNpi(), claimGroup.getClaimFacilityTypeCode(), claimGroup.getClaimFrequencyCode(), claimGroup.getClaimNonPaymentReasonCode(), claimGroup.getPatientDischargeStatusCode(), claimGroup.getClaimServiceClassificationTypeCode(), claimGroup.getClaimPrimaryPayerCode(), claimGroup.getAttendingPhysicianNpi(), claimGroup.getTotalChargeAmount(), claimGroup.getPrimaryPayerPaidAmount(), claimGroup.getFiscalIntermediaryNumber(), claimGroup.getFiDocumentClaimControlNumber(), claimGroup.getFiOriginalClaimControlNumber());
    for (Diagnosis diagnosis : TransformerUtils.extractDiagnoses1Thru12(claimGroup.getDiagnosisAdmittingCode(), claimGroup.getDiagnosisAdmittingCodeVersion(), claimGroup.getDiagnosisPrincipalCode(), claimGroup.getDiagnosisPrincipalCodeVersion(), claimGroup.getDiagnosis1Code(), claimGroup.getDiagnosis1CodeVersion(), claimGroup.getDiagnosis2Code(), claimGroup.getDiagnosis2CodeVersion(), claimGroup.getDiagnosis3Code(), claimGroup.getDiagnosis3CodeVersion(), claimGroup.getDiagnosis4Code(), claimGroup.getDiagnosis4CodeVersion(), claimGroup.getDiagnosis5Code(), claimGroup.getDiagnosis5CodeVersion(), claimGroup.getDiagnosis6Code(), claimGroup.getDiagnosis6CodeVersion(), claimGroup.getDiagnosis7Code(), claimGroup.getDiagnosis7CodeVersion(), claimGroup.getDiagnosis8Code(), claimGroup.getDiagnosis8CodeVersion(), claimGroup.getDiagnosis9Code(), claimGroup.getDiagnosis9CodeVersion(), claimGroup.getDiagnosis10Code(), claimGroup.getDiagnosis10CodeVersion(), claimGroup.getDiagnosis11Code(), claimGroup.getDiagnosis11CodeVersion(), claimGroup.getDiagnosis12Code(), claimGroup.getDiagnosis12CodeVersion())) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    for (Diagnosis diagnosis : TransformerUtils.extractDiagnoses13Thru25(claimGroup.getDiagnosis13Code(), claimGroup.getDiagnosis13CodeVersion(), claimGroup.getDiagnosis14Code(), claimGroup.getDiagnosis14CodeVersion(), claimGroup.getDiagnosis15Code(), claimGroup.getDiagnosis15CodeVersion(), claimGroup.getDiagnosis16Code(), claimGroup.getDiagnosis16CodeVersion(), claimGroup.getDiagnosis17Code(), claimGroup.getDiagnosis17CodeVersion(), claimGroup.getDiagnosis18Code(), claimGroup.getDiagnosis18CodeVersion(), claimGroup.getDiagnosis19Code(), claimGroup.getDiagnosis19CodeVersion(), claimGroup.getDiagnosis20Code(), claimGroup.getDiagnosis20CodeVersion(), claimGroup.getDiagnosis21Code(), claimGroup.getDiagnosis21CodeVersion(), claimGroup.getDiagnosis22Code(), claimGroup.getDiagnosis22CodeVersion(), claimGroup.getDiagnosis23Code(), claimGroup.getDiagnosis23CodeVersion(), claimGroup.getDiagnosis24Code(), claimGroup.getDiagnosis24CodeVersion(), claimGroup.getDiagnosis25Code(), claimGroup.getDiagnosis25CodeVersion())) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    for (Diagnosis diagnosis : TransformerUtils.extractExternalDiagnoses1Thru12(claimGroup.getDiagnosisExternalFirstCode(), claimGroup.getDiagnosisExternalFirstCodeVersion(), claimGroup.getDiagnosisExternal1Code(), claimGroup.getDiagnosisExternal1CodeVersion(), claimGroup.getDiagnosisExternal2Code(), claimGroup.getDiagnosisExternal2CodeVersion(), claimGroup.getDiagnosisExternal3Code(), claimGroup.getDiagnosisExternal3CodeVersion(), claimGroup.getDiagnosisExternal4Code(), claimGroup.getDiagnosisExternal4CodeVersion(), claimGroup.getDiagnosisExternal5Code(), claimGroup.getDiagnosisExternal5CodeVersion(), claimGroup.getDiagnosisExternal6Code(), claimGroup.getDiagnosisExternal6CodeVersion(), claimGroup.getDiagnosisExternal7Code(), claimGroup.getDiagnosisExternal7CodeVersion(), claimGroup.getDiagnosisExternal8Code(), claimGroup.getDiagnosisExternal8CodeVersion(), claimGroup.getDiagnosisExternal9Code(), claimGroup.getDiagnosisExternal9CodeVersion(), claimGroup.getDiagnosisExternal10Code(), claimGroup.getDiagnosisExternal10CodeVersion(), claimGroup.getDiagnosisExternal11Code(), claimGroup.getDiagnosisExternal11CodeVersion(), claimGroup.getDiagnosisExternal12Code(), claimGroup.getDiagnosisExternal12CodeVersion())) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    for (CCWProcedure procedure : TransformerUtils.extractCCWProcedures(claimGroup.getProcedure1Code(), claimGroup.getProcedure1CodeVersion(), claimGroup.getProcedure1Date(), claimGroup.getProcedure2Code(), claimGroup.getProcedure2CodeVersion(), claimGroup.getProcedure2Date(), claimGroup.getProcedure3Code(), claimGroup.getProcedure3CodeVersion(), claimGroup.getProcedure3Date(), claimGroup.getProcedure4Code(), claimGroup.getProcedure4CodeVersion(), claimGroup.getProcedure4Date(), claimGroup.getProcedure5Code(), claimGroup.getProcedure5CodeVersion(), claimGroup.getProcedure5Date(), claimGroup.getProcedure6Code(), claimGroup.getProcedure6CodeVersion(), claimGroup.getProcedure6Date(), claimGroup.getProcedure7Code(), claimGroup.getProcedure7CodeVersion(), claimGroup.getProcedure7Date(), claimGroup.getProcedure8Code(), claimGroup.getProcedure8CodeVersion(), claimGroup.getProcedure8Date(), claimGroup.getProcedure9Code(), claimGroup.getProcedure9CodeVersion(), claimGroup.getProcedure9Date(), claimGroup.getProcedure10Code(), claimGroup.getProcedure10CodeVersion(), claimGroup.getProcedure10Date(), claimGroup.getProcedure11Code(), claimGroup.getProcedure11CodeVersion(), claimGroup.getProcedure11Date(), claimGroup.getProcedure12Code(), claimGroup.getProcedure12CodeVersion(), claimGroup.getProcedure12Date(), claimGroup.getProcedure13Code(), claimGroup.getProcedure13CodeVersion(), claimGroup.getProcedure13Date(), claimGroup.getProcedure14Code(), claimGroup.getProcedure14CodeVersion(), claimGroup.getProcedure14Date(), claimGroup.getProcedure15Code(), claimGroup.getProcedure15CodeVersion(), claimGroup.getProcedure15Date(), claimGroup.getProcedure16Code(), claimGroup.getProcedure16CodeVersion(), claimGroup.getProcedure16Date(), claimGroup.getProcedure17Code(), claimGroup.getProcedure17CodeVersion(), claimGroup.getProcedure17Date(), claimGroup.getProcedure18Code(), claimGroup.getProcedure18CodeVersion(), claimGroup.getProcedure18Date(), claimGroup.getProcedure19Code(), claimGroup.getProcedure19CodeVersion(), claimGroup.getProcedure19Date(), claimGroup.getProcedure20Code(), claimGroup.getProcedure20CodeVersion(), claimGroup.getProcedure20Date(), claimGroup.getProcedure21Code(), claimGroup.getProcedure21CodeVersion(), claimGroup.getProcedure21Date(), claimGroup.getProcedure22Code(), claimGroup.getProcedure22CodeVersion(), claimGroup.getProcedure22Date(), claimGroup.getProcedure23Code(), claimGroup.getProcedure23CodeVersion(), claimGroup.getProcedure23Date(), claimGroup.getProcedure24Code(), claimGroup.getProcedure24CodeVersion(), claimGroup.getProcedure24Date(), claimGroup.getProcedure25Code(), claimGroup.getProcedure25CodeVersion(), claimGroup.getProcedure25Date())) TransformerUtils.addProcedureCode(eob, procedure);
    for (SNFClaimLine claimLine : claimGroup.getLines()) {
        ItemComponent item = eob.addItem();
        item.setSequence(claimLine.getLineNumber().intValue());
        item.setLocation(new Address().setState((claimGroup.getProviderStateCode())));
        TransformerUtils.mapHcpcs(eob, item, Optional.empty(), claimLine.getHcpcsCode(), Collections.emptyList());
        // Common item level fields between Inpatient, Outpatient, HHA, Hospice and SNF
        TransformerUtils.mapEobCommonItemRevenue(item, eob, claimLine.getRevenueCenter(), claimLine.getRateAmount(), claimLine.getTotalChargeAmount(), claimLine.getNonCoveredChargeAmount(), BigDecimal.valueOf(claimLine.getUnitCount()), claimLine.getNationalDrugCodeQuantity(), claimLine.getNationalDrugCodeQualifierCode(), claimLine.getRevenueCenterRenderingPhysicianNPI());
        // Common group level field coinsurance between Inpatient, HHA, Hospice and SNF
        TransformerUtils.mapEobCommonGroupInpHHAHospiceSNFCoinsurance(eob, item, claimLine.getDeductibleCoinsuranceCd());
    }
    TransformerUtils.setLastUpdated(eob, claimGroup.getLastUpdated());
    return eob;
}

Example 7 with CCWProcedure

use of gov.cms.bfd.server.war.commons.CCWProcedure in project beneficiary-fhir-data by CMSgov.

the class InpatientClaimTransformerTest method assertMatches.

/**
 * Verifies that the {@link ExplanationOfBenefit} "looks like" it should, if it were produced from
 * the specified {@link InpatientClaim}.
 *
 * @param claim the {@link InpatientClaim} that the {@link ExplanationOfBenefit} was generated
 *     from
 * @param eob the {@link ExplanationOfBenefit} that was generated from the specified {@link
 *     InpatientClaim}
 * @throws FHIRException (indicates test failure)
 */
static void assertMatches(InpatientClaim claim, ExplanationOfBenefit eob) throws FHIRException {
    // Test to ensure group level fields between all claim types match
    TransformerTestUtils.assertEobCommonClaimHeaderData(eob, claim.getClaimId(), claim.getBeneficiaryId(), ClaimType.INPATIENT, claim.getClaimGroupId().toPlainString(), MedicareSegment.PART_A, Optional.of(claim.getDateFrom()), Optional.of(claim.getDateThrough()), Optional.of(claim.getPaymentAmount()), claim.getFinalAction());
    // test the common field provider number is set as expected in the EOB
    TransformerTestUtils.assertProviderNumber(eob, claim.getProviderNumber());
    if (claim.getPatientStatusCd().isPresent())
        TransformerTestUtils.assertInfoWithCodeEquals(CcwCodebookVariable.NCH_PTNT_STUS_IND_CD, CcwCodebookVariable.NCH_PTNT_STUS_IND_CD, claim.getPatientStatusCd(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.CLM_PASS_THRU_PER_DIEM_AMT, claim.getPassThruPerDiemAmount(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.NCH_PROFNL_CMPNT_CHRG_AMT, claim.getProfessionalComponentCharge(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.CLM_TOT_PPS_CPTL_AMT, claim.getClaimTotalPPSCapitalAmount(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.IME_OP_CLM_VAL_AMT, claim.getIndirectMedicalEducationAmount(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.DSH_OP_CLM_VAL_AMT, claim.getDisproportionateShareAmount(), eob);
    // test common eob information between Inpatient, HHA, Hospice and SNF claims are set as
    // expected
    TransformerTestUtils.assertEobCommonGroupInpHHAHospiceSNFEquals(eob, claim.getClaimAdmissionDate(), claim.getBeneficiaryDischargeDate(), Optional.of(claim.getUtilizationDayCount()));
    // test common benefit components between SNF and Inpatient claims are set as expected
    TransformerTestUtils.assertCommonGroupInpatientSNF(eob, claim.getCoinsuranceDayCount(), claim.getNonUtilizationDayCount(), claim.getDeductibleAmount(), claim.getPartACoinsuranceLiabilityAmount(), claim.getBloodPintsFurnishedQty(), claim.getNoncoveredCharge(), claim.getTotalDeductionAmount(), claim.getClaimPPSCapitalDisproportionateShareAmt(), claim.getClaimPPSCapitalExceptionAmount(), claim.getClaimPPSCapitalFSPAmount(), claim.getClaimPPSCapitalIMEAmount(), claim.getClaimPPSCapitalOutlierAmount(), claim.getClaimPPSOldCapitalHoldHarmlessAmount());
    // test common eob information between SNF and Inpatient claims are set as expected
    TransformerTestUtils.assertCommonEobInformationInpatientSNF(eob, claim.getNoncoveredStayFromDate(), claim.getNoncoveredStayThroughDate(), claim.getCoveredCareThoughDate(), claim.getMedicareBenefitsExhaustedDate(), claim.getDiagnosisRelatedGroupCd());
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.NCH_DRG_OUTLIER_APRVD_PMT_AMT, claim.getDrgOutlierApprovedPaymentAmount(), eob);
    // Test to ensure common group fields between Inpatient, Outpatient and SNF
    // match
    TransformerTestUtils.assertEobCommonGroupInpOutSNFEquals(eob, claim.getBloodDeductibleLiabilityAmount(), claim.getOperatingPhysicianNpi(), claim.getOtherPhysicianNpi(), claim.getClaimQueryCode(), claim.getMcoPaidSw());
    // Test to ensure common group fields between Inpatient, Outpatient HHA, Hospice
    // and SNF match
    TransformerTestUtils.assertEobCommonGroupInpOutHHAHospiceSNFEquals(eob, claim.getOrganizationNpi(), claim.getClaimFacilityTypeCode(), claim.getClaimFrequencyCode(), claim.getClaimNonPaymentReasonCode(), claim.getPatientDischargeStatusCode(), claim.getClaimServiceClassificationTypeCode(), claim.getClaimPrimaryPayerCode(), claim.getAttendingPhysicianNpi(), claim.getTotalChargeAmount(), claim.getPrimaryPayerPaidAmount(), claim.getFiscalIntermediaryNumber(), claim.getFiDocumentClaimControlNumber(), claim.getFiOriginalClaimControlNumber());
    assertEquals(9, eob.getDiagnosis().size());
    // test to ensure the diagnosis code display lookup table process works
    Optional<Diagnosis> diagnosis = Diagnosis.from(claim.getDiagnosis5Code(), claim.getDiagnosis5CodeVersion());
    TransformerTestUtils.assertHasCoding(diagnosis.get().getFhirSystem(), null, TransformerUtils.retrieveIcdCodeDisplay(diagnosis.get().getCode()), diagnosis.get().getCode(), eob.getDiagnosis().get(6).getDiagnosisCodeableConcept().getCoding());
    CCWProcedure ccwProcedure = new CCWProcedure(claim.getProcedure1Code(), claim.getProcedure1CodeVersion(), claim.getProcedure1Date());
    TransformerTestUtils.assertHasCoding(ccwProcedure.getFhirSystem().toString(), claim.getProcedure1Code().get(), eob.getProcedure().get(0).getProcedureCodeableConcept().getCoding());
    assertEquals(TransformerUtils.convertToDate(claim.getProcedure1Date().get()), eob.getProcedure().get(0).getDate());
    // test to ensure the procedure code display lookup table process works
    CCWProcedure ccwProcedureDisplay = new CCWProcedure(claim.getProcedure6Code(), claim.getProcedure6CodeVersion(), claim.getProcedure6Date());
    TransformerTestUtils.assertHasCoding(ccwProcedureDisplay.getFhirSystem().toString(), null, TransformerUtils.retrieveProcedureCodeDisplay(claim.getProcedure6Code().get()), claim.getProcedure6Code().get(), eob.getProcedure().get(5).getProcedureCodeableConcept().getCoding());
    assertEquals(1, eob.getItem().size());
    ItemComponent eobItem0 = eob.getItem().get(0);
    InpatientClaimLine claimLine1 = claim.getLines().get(0);
    assertEquals(claimLine1.getLineNumber(), new BigDecimal(eobItem0.getSequence()));
    assertEquals(claim.getProviderStateCode(), eobItem0.getLocationAddress().getState());
    TransformerTestUtils.assertHcpcsCodes(eobItem0, claimLine1.getHcpcsCode(), Optional.empty(), Optional.empty(), Optional.empty(), 0);
    // Test to ensure common group field coinsurance between Inpatient, HHA, Hospice and SNF match
    TransformerTestUtils.assertEobCommonGroupInpHHAHospiceSNFCoinsuranceEquals(eobItem0, claimLine1.getDeductibleCoinsuranceCd());
    String claimControlNumber = "0000000000";
    // Test to ensure item level fields between Inpatient, Outpatient, HHA, Hopsice
    // and SNF match
    TransformerTestUtils.assertEobCommonItemRevenueEquals(eobItem0, eob, claimLine1.getRevenueCenter(), claimLine1.getRateAmount(), claimLine1.getTotalChargeAmount(), claimLine1.getNonCoveredChargeAmount(), claimLine1.getUnitCount(), claimControlNumber, claimLine1.getNationalDrugCodeQuantity(), claimLine1.getNationalDrugCodeQualifierCode(), claimLine1.getRevenueCenterRenderingPhysicianNPI(), 0);
    // verify {@link
    // TransformerUtils#mapEobType(CodeableConcept,ClaimType,Optional,Optional)}
    // method worked as expected for this claim type
    TransformerTestUtils.assertMapEobType(eob.getType(), ClaimType.INPATIENT, Optional.of(org.hl7.fhir.dstu3.model.codesystems.ClaimType.INSTITUTIONAL), Optional.of(claim.getNearLineRecordIdCode()), Optional.of(claim.getClaimTypeCode()));
    // Test lastUpdated
    TransformerTestUtils.assertLastUpdatedEquals(claim.getLastUpdated(), eob);
}

Example 8 with CCWProcedure

use of gov.cms.bfd.server.war.commons.CCWProcedure in project beneficiary-fhir-data by CMSgov.

the class TransformerUtilsV2 method addProcedureCode.

/**
 * @param eob the {@link ExplanationOfBenefit} to (possibly) modify
 * @param procedure the {@link CCWProcedure} to add, if it's not already present
 * @return the {@link ProcedureComponent#getSequence()} of the existing or newly-added entry
 */
static int addProcedureCode(ExplanationOfBenefit eob, CCWProcedure procedure) {
    Optional<ProcedureComponent> existingProcedure = eob.getProcedure().stream().filter(pc -> pc.getProcedure() instanceof CodeableConcept).filter(pc -> isCodeInConcept((CodeableConcept) pc.getProcedure(), procedure.getFhirSystem(), procedure.getCode())).findAny();
    if (existingProcedure.isPresent()) {
        return existingProcedure.get().getSequenceElement().getValue();
    }
    ProcedureComponent procedureComponent = new ProcedureComponent().setSequence(eob.getProcedure().size() + 1).setProcedure(createCodeableConcept(procedure.getFhirSystem(), null, retrieveProcedureCodeDisplay(procedure.getCode()), procedure.getCode()));
    if (procedure.getProcedureDate().isPresent()) {
        procedureComponent.setDate(convertToDate(procedure.getProcedureDate().get()));
    }
    eob.getProcedure().add(procedureComponent);
    return procedureComponent.getSequenceElement().getValue();
}

Example 9 with CCWProcedure

use of gov.cms.bfd.server.war.commons.CCWProcedure in project beneficiary-fhir-data by CMSgov.

the class OutpatientClaimTransformer method transformClaim.

/**
 * @param claimGroup the CCW {@link OutpatientClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     OutpatientClaim}
 */
private static ExplanationOfBenefit transformClaim(OutpatientClaim claimGroup) {
    ExplanationOfBenefit eob = new ExplanationOfBenefit();
    // Common group level fields between all claim types
    TransformerUtils.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimType.OUTPATIENT, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
    TransformerUtils.mapEobWeeklyProcessDate(eob, claimGroup.getWeeklyProcessDate());
    // map eob type codes into FHIR
    TransformerUtils.mapEobType(eob, ClaimType.OUTPATIENT, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
    // set the provider number which is common among several claim types
    TransformerUtils.setProviderNumber(eob, claimGroup.getProviderNumber());
    // TODO If this is actually nullable, should be Optional.
    if (claimGroup.getProfessionalComponentCharge() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.NCH_PROFNL_CMPNT_CHRG_AMT, claimGroup.getProfessionalComponentCharge());
    }
    // TODO If this is actually nullable, should be Optional.
    if (claimGroup.getDeductibleAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.NCH_BENE_PTB_DDCTBL_AMT, claimGroup.getDeductibleAmount());
    }
    // TODO If this is actually nullable, should be Optional.
    if (claimGroup.getCoinsuranceAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.NCH_BENE_PTB_COINSRNC_AMT, claimGroup.getCoinsuranceAmount());
    }
    // TODO If this is actually nullable, should be Optional.
    if (claimGroup.getProviderPaymentAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.CLM_OP_PRVDR_PMT_AMT, claimGroup.getProviderPaymentAmount());
    }
    // TODO If this is actually nullable, should be Optional.
    if (claimGroup.getBeneficiaryPaymentAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.CLM_OP_BENE_PMT_AMT, claimGroup.getBeneficiaryPaymentAmount());
    }
    // Common group level fields between Inpatient, Outpatient and SNF
    TransformerUtils.mapEobCommonGroupInpOutSNF(eob, claimGroup.getBloodDeductibleLiabilityAmount(), claimGroup.getOperatingPhysicianNpi(), claimGroup.getOtherPhysicianNpi(), claimGroup.getClaimQueryCode(), claimGroup.getMcoPaidSw());
    // Common group level fields between Inpatient, Outpatient Hospice, HHA and SNF
    TransformerUtils.mapEobCommonGroupInpOutHHAHospiceSNF(eob, claimGroup.getOrganizationNpi(), claimGroup.getClaimFacilityTypeCode(), claimGroup.getClaimFrequencyCode(), claimGroup.getClaimNonPaymentReasonCode(), claimGroup.getPatientDischargeStatusCode().get(), claimGroup.getClaimServiceClassificationTypeCode(), claimGroup.getClaimPrimaryPayerCode(), claimGroup.getAttendingPhysicianNpi(), claimGroup.getTotalChargeAmount(), claimGroup.getPrimaryPayerPaidAmount(), claimGroup.getFiscalIntermediaryNumber(), claimGroup.getFiDocumentClaimControlNumber(), claimGroup.getFiOriginalClaimControlNumber());
    for (Diagnosis diagnosis : TransformerUtils.extractDiagnoses1Thru12(claimGroup.getDiagnosisPrincipalCode(), claimGroup.getDiagnosisPrincipalCodeVersion(), claimGroup.getDiagnosis1Code(), claimGroup.getDiagnosis1CodeVersion(), claimGroup.getDiagnosis2Code(), claimGroup.getDiagnosis2CodeVersion(), claimGroup.getDiagnosis3Code(), claimGroup.getDiagnosis3CodeVersion(), claimGroup.getDiagnosis4Code(), claimGroup.getDiagnosis4CodeVersion(), claimGroup.getDiagnosis5Code(), claimGroup.getDiagnosis5CodeVersion(), claimGroup.getDiagnosis6Code(), claimGroup.getDiagnosis6CodeVersion(), claimGroup.getDiagnosis7Code(), claimGroup.getDiagnosis7CodeVersion(), claimGroup.getDiagnosis8Code(), claimGroup.getDiagnosis8CodeVersion(), claimGroup.getDiagnosis9Code(), claimGroup.getDiagnosis9CodeVersion(), claimGroup.getDiagnosis10Code(), claimGroup.getDiagnosis10CodeVersion(), claimGroup.getDiagnosis11Code(), claimGroup.getDiagnosis11CodeVersion(), claimGroup.getDiagnosis12Code(), claimGroup.getDiagnosis12CodeVersion())) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    for (Diagnosis diagnosis : TransformerUtils.extractDiagnoses13Thru25(claimGroup.getDiagnosis13Code(), claimGroup.getDiagnosis13CodeVersion(), claimGroup.getDiagnosis14Code(), claimGroup.getDiagnosis14CodeVersion(), claimGroup.getDiagnosis15Code(), claimGroup.getDiagnosis15CodeVersion(), claimGroup.getDiagnosis16Code(), claimGroup.getDiagnosis16CodeVersion(), claimGroup.getDiagnosis17Code(), claimGroup.getDiagnosis17CodeVersion(), claimGroup.getDiagnosis18Code(), claimGroup.getDiagnosis18CodeVersion(), claimGroup.getDiagnosis19Code(), claimGroup.getDiagnosis19CodeVersion(), claimGroup.getDiagnosis20Code(), claimGroup.getDiagnosis20CodeVersion(), claimGroup.getDiagnosis21Code(), claimGroup.getDiagnosis21CodeVersion(), claimGroup.getDiagnosis22Code(), claimGroup.getDiagnosis22CodeVersion(), claimGroup.getDiagnosis23Code(), claimGroup.getDiagnosis23CodeVersion(), claimGroup.getDiagnosis24Code(), claimGroup.getDiagnosis24CodeVersion(), claimGroup.getDiagnosis25Code(), claimGroup.getDiagnosis25CodeVersion())) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    for (Diagnosis diagnosis : TransformerUtils.extractExternalDiagnoses1Thru12(claimGroup.getDiagnosisExternalFirstCode(), claimGroup.getDiagnosisExternalFirstCodeVersion(), claimGroup.getDiagnosisExternal1Code(), claimGroup.getDiagnosisExternal1CodeVersion(), claimGroup.getDiagnosisExternal2Code(), claimGroup.getDiagnosisExternal2CodeVersion(), claimGroup.getDiagnosisExternal3Code(), claimGroup.getDiagnosisExternal3CodeVersion(), claimGroup.getDiagnosisExternal4Code(), claimGroup.getDiagnosisExternal4CodeVersion(), claimGroup.getDiagnosisExternal5Code(), claimGroup.getDiagnosisExternal5CodeVersion(), claimGroup.getDiagnosisExternal6Code(), claimGroup.getDiagnosisExternal6CodeVersion(), claimGroup.getDiagnosisExternal7Code(), claimGroup.getDiagnosisExternal7CodeVersion(), claimGroup.getDiagnosisExternal8Code(), claimGroup.getDiagnosisExternal8CodeVersion(), claimGroup.getDiagnosisExternal9Code(), claimGroup.getDiagnosisExternal9CodeVersion(), claimGroup.getDiagnosisExternal10Code(), claimGroup.getDiagnosisExternal10CodeVersion(), claimGroup.getDiagnosisExternal11Code(), claimGroup.getDiagnosisExternal11CodeVersion(), claimGroup.getDiagnosisExternal12Code(), claimGroup.getDiagnosisExternal12CodeVersion())) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    if (claimGroup.getDiagnosisAdmission1Code().isPresent())
        TransformerUtils.addDiagnosisCode(eob, Diagnosis.from(claimGroup.getDiagnosisAdmission1Code(), claimGroup.getDiagnosisAdmission1CodeVersion(), DiagnosisLabel.REASONFORVISIT).get());
    if (claimGroup.getDiagnosisAdmission2Code().isPresent())
        TransformerUtils.addDiagnosisCode(eob, Diagnosis.from(claimGroup.getDiagnosisAdmission2Code(), claimGroup.getDiagnosisAdmission2CodeVersion(), DiagnosisLabel.REASONFORVISIT).get());
    if (claimGroup.getDiagnosisAdmission3Code().isPresent())
        TransformerUtils.addDiagnosisCode(eob, Diagnosis.from(claimGroup.getDiagnosisAdmission3Code(), claimGroup.getDiagnosisAdmission3CodeVersion(), DiagnosisLabel.REASONFORVISIT).get());
    for (CCWProcedure procedure : TransformerUtils.extractCCWProcedures(claimGroup.getProcedure1Code(), claimGroup.getProcedure1CodeVersion(), claimGroup.getProcedure1Date(), claimGroup.getProcedure2Code(), claimGroup.getProcedure2CodeVersion(), claimGroup.getProcedure2Date(), claimGroup.getProcedure3Code(), claimGroup.getProcedure3CodeVersion(), claimGroup.getProcedure3Date(), claimGroup.getProcedure4Code(), claimGroup.getProcedure4CodeVersion(), claimGroup.getProcedure4Date(), claimGroup.getProcedure5Code(), claimGroup.getProcedure5CodeVersion(), claimGroup.getProcedure5Date(), claimGroup.getProcedure6Code(), claimGroup.getProcedure6CodeVersion(), claimGroup.getProcedure6Date(), claimGroup.getProcedure7Code(), claimGroup.getProcedure7CodeVersion(), claimGroup.getProcedure7Date(), claimGroup.getProcedure8Code(), claimGroup.getProcedure8CodeVersion(), claimGroup.getProcedure8Date(), claimGroup.getProcedure9Code(), claimGroup.getProcedure9CodeVersion(), claimGroup.getProcedure9Date(), claimGroup.getProcedure10Code(), claimGroup.getProcedure10CodeVersion(), claimGroup.getProcedure10Date(), claimGroup.getProcedure11Code(), claimGroup.getProcedure11CodeVersion(), claimGroup.getProcedure11Date(), claimGroup.getProcedure12Code(), claimGroup.getProcedure12CodeVersion(), claimGroup.getProcedure12Date(), claimGroup.getProcedure13Code(), claimGroup.getProcedure13CodeVersion(), claimGroup.getProcedure13Date(), claimGroup.getProcedure14Code(), claimGroup.getProcedure14CodeVersion(), claimGroup.getProcedure14Date(), claimGroup.getProcedure15Code(), claimGroup.getProcedure15CodeVersion(), claimGroup.getProcedure15Date(), claimGroup.getProcedure16Code(), claimGroup.getProcedure16CodeVersion(), claimGroup.getProcedure16Date(), claimGroup.getProcedure17Code(), claimGroup.getProcedure17CodeVersion(), claimGroup.getProcedure17Date(), claimGroup.getProcedure18Code(), claimGroup.getProcedure18CodeVersion(), claimGroup.getProcedure18Date(), claimGroup.getProcedure19Code(), claimGroup.getProcedure19CodeVersion(), claimGroup.getProcedure19Date(), claimGroup.getProcedure20Code(), claimGroup.getProcedure20CodeVersion(), claimGroup.getProcedure20Date(), claimGroup.getProcedure21Code(), claimGroup.getProcedure21CodeVersion(), claimGroup.getProcedure21Date(), claimGroup.getProcedure22Code(), claimGroup.getProcedure22CodeVersion(), claimGroup.getProcedure22Date(), claimGroup.getProcedure23Code(), claimGroup.getProcedure23CodeVersion(), claimGroup.getProcedure23Date(), claimGroup.getProcedure24Code(), claimGroup.getProcedure24CodeVersion(), claimGroup.getProcedure24Date(), claimGroup.getProcedure25Code(), claimGroup.getProcedure25CodeVersion(), claimGroup.getProcedure25Date())) TransformerUtils.addProcedureCode(eob, procedure);
    for (OutpatientClaimLine claimLine : claimGroup.getLines()) {
        ItemComponent item = eob.addItem();
        item.setSequence(claimLine.getLineNumber().intValue());
        item.setLocation(new Address().setState((claimGroup.getProviderStateCode())));
        if (claimLine.getRevCntr1stAnsiCd().isPresent()) {
            item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_1ST_ANSI_CD)).setReason(TransformerUtils.createCodeableConcept(eob, CcwCodebookVariable.REV_CNTR_1ST_ANSI_CD, claimLine.getRevCntr1stAnsiCd()));
        }
        if (claimLine.getRevCntr2ndAnsiCd().isPresent()) {
            item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_2ND_ANSI_CD)).setReason(TransformerUtils.createCodeableConcept(eob, CcwCodebookVariable.REV_CNTR_2ND_ANSI_CD, claimLine.getRevCntr2ndAnsiCd()));
        }
        if (claimLine.getRevCntr3rdAnsiCd().isPresent()) {
            item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_3RD_ANSI_CD)).setReason(TransformerUtils.createCodeableConcept(eob, CcwCodebookVariable.REV_CNTR_3RD_ANSI_CD, claimLine.getRevCntr3rdAnsiCd()));
        }
        if (claimLine.getRevCntr4thAnsiCd().isPresent()) {
            item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_4TH_ANSI_CD)).setReason(TransformerUtils.createCodeableConcept(eob, CcwCodebookVariable.REV_CNTR_4TH_ANSI_CD, claimLine.getRevCntr4thAnsiCd()));
        }
        TransformerUtils.mapHcpcs(eob, item, Optional.empty(), claimLine.getHcpcsCode(), Arrays.asList(claimLine.getHcpcsInitialModifierCode(), claimLine.getHcpcsSecondModifierCode()));
        if (claimLine.getNationalDrugCode().isPresent()) {
            item.getService().addExtension(TransformerUtils.createExtensionCoding(eob, CcwCodebookVariable.REV_CNTR_IDE_NDC_UPC_NUM, claimLine.getNationalDrugCode()));
        }
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_BLOOD_DDCTBL_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getBloodDeductibleAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_CASH_DDCTBL_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getCashDeductibleAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_COINSRNC_WGE_ADJSTD_C)).setAmount(TransformerUtils.createMoney(claimLine.getWageAdjustedCoinsuranceAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_RDCD_COINSRNC_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getReducedCoinsuranceAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_1ST_MSP_PD_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getFirstMspPaidAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_2ND_MSP_PD_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getSecondMspPaidAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_PRVDR_PMT_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getProviderPaymentAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_BENE_PMT_AMT)).setAmount(TransformerUtils.createMoney(claimLine.getBenficiaryPaymentAmount()));
        item.addAdjudication().setCategory(TransformerUtils.createAdjudicationCategory(CcwCodebookVariable.REV_CNTR_PTNT_RSPNSBLTY_PMT)).setAmount(TransformerUtils.createMoney(claimLine.getPatientResponsibilityAmount()));
        // Common item level fields between Outpatient, HHA and Hospice
        TransformerUtils.mapEobCommonItemRevenueOutHHAHospice(item, claimLine.getRevenueCenterDate(), claimLine.getPaymentAmount());
        // Common item level fields between Inpatient, Outpatient, HHA, Hospice and SNF
        TransformerUtils.mapEobCommonItemRevenue(item, eob, claimLine.getRevenueCenterCode(), claimLine.getRateAmount(), claimLine.getTotalChargeAmount(), claimLine.getNonCoveredChargeAmount(), claimLine.getUnitCount(), claimLine.getNationalDrugCodeQuantity(), claimLine.getNationalDrugCodeQualifierCode(), claimLine.getRevenueCenterRenderingPhysicianNPI());
        // Dt: 6-18-20 Handling for optional status code claim line: BFD-252
        if (claimLine.getStatusCode().isPresent()) {
            item.getRevenue().addExtension(TransformerUtils.createExtensionCoding(eob, CcwCodebookVariable.REV_CNTR_STUS_IND_CD, claimLine.getStatusCode()));
        }
    }
    TransformerUtils.setLastUpdated(eob, claimGroup.getLastUpdated());
    return eob;
}

Example 10 with CCWProcedure

use of gov.cms.bfd.server.war.commons.CCWProcedure in project beneficiary-fhir-data by CMSgov.

the class SNFClaimTransformerTest method assertMatches.

/**
 * Verifies that the {@link ExplanationOfBenefit} "looks like" it should, if it were produced from
 * the specified {@link SNFClaim}.
 *
 * @param claim the {@link SNFClaim} that the {@link ExplanationOfBenefit} was generated from
 * @param eob the {@link ExplanationOfBenefit} that was generated from the specified {@link
 *     SNFClaim}
 * @throws FHIRException (indicates test failure)
 */
static void assertMatches(SNFClaim claim, ExplanationOfBenefit eob) throws FHIRException {
    // Test to ensure group level fields between all claim types match
    TransformerTestUtils.assertEobCommonClaimHeaderData(eob, claim.getClaimId(), claim.getBeneficiaryId(), ClaimType.SNF, claim.getClaimGroupId().toPlainString(), MedicareSegment.PART_A, Optional.of(claim.getDateFrom()), Optional.of(claim.getDateThrough()), Optional.of(claim.getPaymentAmount()), claim.getFinalAction());
    // test the common field provider number is set as expected in the EOB
    TransformerTestUtils.assertProviderNumber(eob, claim.getProviderNumber());
    // test common benefit components between SNF and Inpatient claims are set as expected
    TransformerTestUtils.assertCommonGroupInpatientSNF(eob, claim.getCoinsuranceDayCount(), claim.getNonUtilizationDayCount(), claim.getDeductibleAmount(), claim.getPartACoinsuranceLiabilityAmount(), claim.getBloodPintsFurnishedQty(), claim.getNoncoveredCharge(), claim.getTotalDeductionAmount(), claim.getClaimPPSCapitalDisproportionateShareAmt(), claim.getClaimPPSCapitalExceptionAmount(), claim.getClaimPPSCapitalFSPAmount(), claim.getClaimPPSCapitalIMEAmount(), claim.getClaimPPSCapitalOutlierAmount(), claim.getClaimPPSOldCapitalHoldHarmlessAmount());
    if (claim.getQualifiedStayFromDate().isPresent() || claim.getQualifiedStayThroughDate().isPresent()) {
        SupportingInformationComponent nchQlyfdStayInfo = TransformerTestUtils.assertHasInfo(CcwCodebookVariable.NCH_QLFYD_STAY_FROM_DT, eob);
        TransformerTestUtils.assertPeriodEquals(claim.getQualifiedStayFromDate(), claim.getQualifiedStayThroughDate(), (Period) nchQlyfdStayInfo.getTiming());
    }
    // test common eob information between SNF and Inpatient claims are set as expected
    TransformerTestUtils.assertCommonEobInformationInpatientSNF(eob, claim.getNoncoveredStayFromDate(), claim.getNoncoveredStayThroughDate(), claim.getCoveredCareThroughDate(), claim.getMedicareBenefitsExhaustedDate(), claim.getDiagnosisRelatedGroupCd());
    TransformerTestUtils.assertDateEquals(claim.getClaimAdmissionDate().get(), eob.getHospitalization().getStartElement());
    TransformerTestUtils.assertDateEquals(claim.getBeneficiaryDischargeDate().get(), eob.getHospitalization().getEndElement());
    // test common eob information between Inpatient, HHA, Hospice and SNF claims are set as
    // expected
    TransformerTestUtils.assertEobCommonGroupInpHHAHospiceSNFEquals(eob, claim.getClaimAdmissionDate(), claim.getBeneficiaryDischargeDate(), Optional.of(claim.getUtilizationDayCount()));
    // Test to ensure common group fields between Inpatient, Outpatient and SNF
    TransformerTestUtils.assertEobCommonGroupInpOutSNFEquals(eob, claim.getBloodDeductibleLiabilityAmount(), claim.getOperatingPhysicianNpi(), claim.getOtherPhysicianNpi(), claim.getClaimQueryCode(), claim.getMcoPaidSw());
    // Test to ensure common group fields between Inpatient, Outpatient HHA, Hospice
    // and SNF match
    TransformerTestUtils.assertEobCommonGroupInpOutHHAHospiceSNFEquals(eob, claim.getOrganizationNpi(), claim.getClaimFacilityTypeCode(), claim.getClaimFrequencyCode(), claim.getClaimNonPaymentReasonCode(), claim.getPatientDischargeStatusCode(), claim.getClaimServiceClassificationTypeCode(), claim.getClaimPrimaryPayerCode(), claim.getAttendingPhysicianNpi(), claim.getTotalChargeAmount(), claim.getPrimaryPayerPaidAmount(), claim.getFiscalIntermediaryNumber(), claim.getFiDocumentClaimControlNumber(), claim.getFiOriginalClaimControlNumber());
    assertEquals(6, eob.getDiagnosis().size());
    CCWProcedure ccwProcedure = new CCWProcedure(claim.getProcedure1Code(), claim.getProcedure1CodeVersion(), claim.getProcedure1Date());
    TransformerTestUtils.assertHasCoding(ccwProcedure.getFhirSystem().toString(), claim.getProcedure1Code().get(), eob.getProcedure().get(0).getProcedureCodeableConcept().getCoding());
    assertEquals(TransformerUtils.convertToDate(claim.getProcedure1Date().get()), eob.getProcedure().get(0).getDate());
    assertEquals(1, eob.getItem().size());
    SNFClaimLine claimLine1 = claim.getLines().get(0);
    ItemComponent eobItem0 = eob.getItem().get(0);
    assertEquals(claimLine1.getLineNumber(), new BigDecimal(eobItem0.getSequence()));
    assertEquals(claim.getProviderStateCode(), eobItem0.getLocationAddress().getState());
    TransformerTestUtils.assertHasCoding(CcwCodebookVariable.REV_CNTR, claimLine1.getRevenueCenter(), eobItem0.getRevenue());
    TransformerTestUtils.assertHcpcsCodes(eobItem0, claimLine1.getHcpcsCode(), Optional.empty(), Optional.empty(), Optional.empty(), 0);
    // Test to ensure common group field coinsurance between Inpatient, HHA, Hospice and SNF match
    TransformerTestUtils.assertEobCommonGroupInpHHAHospiceSNFCoinsuranceEquals(eobItem0, claimLine1.getDeductibleCoinsuranceCd());
    String claimControlNumber = "0000000000";
    // Test to ensure item level fields between Inpatient, Outpatient, HHA, Hopsice
    // and SNF match
    TransformerTestUtils.assertEobCommonItemRevenueEquals(eobItem0, eob, claimLine1.getRevenueCenter(), claimLine1.getRateAmount(), claimLine1.getTotalChargeAmount(), claimLine1.getNonCoveredChargeAmount(), BigDecimal.valueOf(claimLine1.getUnitCount()), claimControlNumber, claimLine1.getNationalDrugCodeQuantity(), claimLine1.getNationalDrugCodeQualifierCode(), claimLine1.getRevenueCenterRenderingPhysicianNPI(), 1);
    // verify {@link
    // TransformerUtils#mapEobType(CodeableConcept,ClaimType,Optional,Optional)}
    // method worked as expected for this claim type
    TransformerTestUtils.assertMapEobType(eob.getType(), ClaimType.SNF, Optional.of(org.hl7.fhir.dstu3.model.codesystems.ClaimType.INSTITUTIONAL), Optional.of(claim.getNearLineRecordIdCode()), Optional.of(claim.getClaimTypeCode()));
    // Test lastUpdated
    TransformerTestUtils.assertLastUpdatedEquals(claim.getLastUpdated(), eob);
}