use of org.hl7.fhir.dstu2.model.Quantity in project beneficiary-fhir-data by CMSgov.
the class HHAClaimTransformerV2 method transformClaim.
/**
* @param claimGroup the CCW {@link HHAClaim} to transform
* @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
* HHAClaim}
*/
private static ExplanationOfBenefit transformClaim(HHAClaim claimGroup) {
ExplanationOfBenefit eob = new ExplanationOfBenefit();
// Required values not directly mapped
eob.getMeta().addProfile(ProfileConstants.C4BB_EOB_NONCLINICIAN_PROFILE_URL);
// Common group level fields between all claim types
// Claim Type + Claim ID => ExplanationOfBenefit.id
// CLM_ID => ExplanationOfBenefit.identifier
// CLM_GRP_ID => ExplanationOfBenefit.identifier
// BENE_ID + Coverage Type => ExplanationOfBenefit.insurance.coverage
// BENE_ID => ExplanationOfBenefit.patient (reference)
// FINAL_ACTION => ExplanationOfBenefit.status
// CLM_FROM_DT => ExplanationOfBenefit.billablePeriod.start
// CLM_THRU_DT => ExplanationOfBenefit.billablePeriod.end
// CLM_PMT_AMT => ExplanationOfBenefit.payment.amount
TransformerUtilsV2.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimTypeV2.HHA, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
// NCH_WKLY_PROC_DT => ExplanationOfBenefit.supportinginfo.timingDate
TransformerUtilsV2.addInformation(eob, TransformerUtilsV2.createInformationRecievedDateSlice(eob, CcwCodebookVariable.NCH_WKLY_PROC_DT, Optional.of(claimGroup.getWeeklyProcessDate())));
// map eob type codes into FHIR
// NCH_CLM_TYPE_CD => ExplanationOfBenefit.type.coding
// EOB Type => ExplanationOfBenefit.type.coding
// Claim Type => ExplanationOfBenefit.type.coding
// NCH_NEAR_LINE_REC_IDENT_CD => ExplanationOfBenefit.extension
TransformerUtilsV2.mapEobType(eob, ClaimTypeV2.HHA, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
// PRVDR_NUM => ExplanationOfBenefit.provider.identifier
TransformerUtilsV2.addProviderSlice(eob, C4BBOrganizationIdentifierType.PRN, claimGroup.getProviderNumber(), claimGroup.getLastUpdated());
// Common group level fields between Inpatient, Outpatient Hospice, HHA and SNF
// ORG_NPI_NUM => ExplanationOfBenefit.provider
// CLM_FAC_TYPE_CD => ExplanationOfBenefit.facility.extension
// CLM_FREQ_CD => ExplanationOfBenefit.supportingInfo
// CLM_MDCR_NON_PMT_RSN_CD => ExplanationOfBenefit.extension
// PTNT_DSCHRG_STUS_CD => ExplanationOfBenefit.supportingInfo
// CLM_SRVC_CLSFCTN_TYPE_CD => ExplanationOfBenefit.extension
// NCH_PRMRY_PYR_CD => ExplanationOfBenefit.supportingInfo
// CLM_TOT_CHRG_AMT => ExplanationOfBenefit.total.amount
// NCH_PRMRY_PYR_CLM_PD_AMT => ExplanationOfBenefit.benefitBalance.financial
TransformerUtilsV2.mapEobCommonGroupInpOutHHAHospiceSNF(eob, claimGroup.getOrganizationNpi(), claimGroup.getClaimFacilityTypeCode(), claimGroup.getClaimFrequencyCode(), claimGroup.getClaimNonPaymentReasonCode(), claimGroup.getPatientDischargeStatusCode(), claimGroup.getClaimServiceClassificationTypeCode(), claimGroup.getClaimPrimaryPayerCode(), claimGroup.getTotalChargeAmount(), claimGroup.getPrimaryPayerPaidAmount(), claimGroup.getFiscalIntermediaryNumber(), claimGroup.getLastUpdated());
// CLM_PPS_IND_CODE => ExplanationOfBenefit.supportingInfo
TransformerUtilsV2.addInformationWithCode(eob, CcwCodebookVariable.CLM_PPS_IND_CD, CcwCodebookVariable.CLM_PPS_IND_CD, claimGroup.getProspectivePaymentCode());
// ICD_DGNS_E_VRSN_CD(1-12) => diagnosis.diagnosisCodeableConcept
for (Diagnosis diagnosis : DiagnosisUtilV2.extractDiagnoses(claimGroup)) {
DiagnosisUtilV2.addDiagnosisCode(eob, diagnosis, ClaimTypeV2.HHA);
}
// Map care team
// AT_PHYSN_NPI => ExplanationOfBenefit.careTeam.provider
// AT_PHYSN_UPIN => ExplanationOfBenefit.careTeam.provider
TransformerUtilsV2.mapCareTeam(eob, claimGroup.getAttendingPhysicianNpi(), Optional.empty(), Optional.empty(), claimGroup.getAttendingPhysicianUpin(), Optional.empty(), Optional.empty());
// CLM_HHA_LUPA_IND_CD => ExplanationOfBenefit.supportinginfo.code
claimGroup.getClaimLUPACode().ifPresent(c -> TransformerUtilsV2.addInformationWithCode(eob, CcwCodebookVariable.CLM_HHA_LUPA_IND_CD, CcwCodebookVariable.CLM_HHA_LUPA_IND_CD, c));
// CLM_HHA_RFRL_CD => ExplanationOfBenefit.supportinginfo.code
claimGroup.getClaimReferralCode().ifPresent(c -> TransformerUtilsV2.addInformationWithCode(eob, CcwCodebookVariable.CLM_HHA_RFRL_CD, CcwCodebookVariable.CLM_HHA_RFRL_CD, c));
// CLM_HHA_TOT_VISIT_CNT => ExplanationOfBenefit.supportinginfo.value[x]
TransformerUtilsV2.addInformation(eob, CcwCodebookVariable.CLM_HHA_TOT_VISIT_CNT).setValue(new Quantity(claimGroup.getTotalVisitCount().intValue()));
// CLM_ADMSN_DT => ExplanationOfBenefit.supportingInfo:admissionperiod
TransformerUtilsV2.addInformation(eob, TransformerUtilsV2.createInformationAdmPeriodSlice(eob, claimGroup.getCareStartDate(), Optional.empty()));
for (HHAClaimLine line : claimGroup.getLines()) {
ItemComponent item = eob.addItem();
// Override the default sequence
// CLM_LINE_NUM => item.sequence
item.setSequence(line.getLineNumber().intValue());
// PRVDR_STATE_CD => item.location
TransformerUtilsV2.addLocationState(item, claimGroup.getProviderStateCode());
// HCPCS_CD => ExplanationOfBenefit.item.productOrService
// HCPCS_1ST_MDFR_CD => ExplanationOfBenefit.item.modifier
// HCPCS_2ND_MDFR_CD => ExplanationOfBenefit.item.modifier
TransformerUtilsV2.mapHcpcs(eob, item, line.getHcpcsCode(), Optional.empty(), Arrays.asList(line.getHcpcsInitialModifierCode(), line.getHcpcsSecondModifierCode()));
// REV_CNTR_1ST_ANSI_CD => ExplanationOfBenefit.item.adjudication
TransformerUtilsV2.addAdjudication(item, TransformerUtilsV2.createAdjudicationDenialReasonSlice(eob, CcwCodebookVariable.REV_CNTR_1ST_ANSI_CD, line.getRevCntr1stAnsiCd()));
// REV_CNTR => ExplanationOfBenefit.item.revenue
// REV_CNTR_RATE_AMT => ExplanationOfBenefit.item.adjudication
// REV_CNTR_TOT_CHRG_AMT => ExplanationOfBenefit.item.adjudication
// REV_CNTR_NCVRD_CHRG_AMT => ExplanationOfBenefit.item.adjudication
// REV_CNTR_NDC_QTY => ExplanationOfBenefit.item.quantity
// REV_CNTR_NDC_QTY_QLFR_CD => ExplanationOfBenefit.modifier
TransformerUtilsV2.mapEobCommonItemRevenue(item, eob, line.getRevenueCenterCode(), line.getRateAmount(), line.getTotalChargeAmount(), Optional.of(line.getNonCoveredChargeAmount()), line.getNationalDrugCodeQuantity(), line.getNationalDrugCodeQualifierCode());
// Common item level fields between Outpatient, HHA and Hospice
// REV_CNTR_DT => ExplanationOfBenefit.item.servicedDate
// REV_CNTR_PMT_AMT_AMT => ExplanationOfBenefit.item.adjudication
TransformerUtilsV2.mapEobCommonItemRevenueOutHHAHospice(item, line.getRevenueCenterDate(), line.getPaymentAmount());
// REV_CNTR_DDCTBL_COINSRNC_CD => item.revenue
TransformerUtilsV2.addItemRevenue(item, eob, CcwCodebookVariable.REV_CNTR_DDCTBL_COINSRNC_CD, line.getDeductibleCoinsuranceCd());
// RNDRNG_PHYSN_UPIN => ExplanationOfBenefit.careTeam.provider
TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.UPIN, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getRevenueCenterRenderingPhysicianUPIN());
// RNDRNG_PHYSN_NPI => ExplanationOfBenefit.careTeam.provider
TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getRevenueCenterRenderingPhysicianNPI());
// REV_CNTR_STUS_IND_CD => ExplanationOfBenefit.item.revenue.extension
TransformerUtilsV2.mapEobCommonItemRevenueStatusCode(item, eob, line.getStatusCode());
}
TransformerUtilsV2.setLastUpdated(eob, claimGroup.getLastUpdated());
return eob;
}
use of org.hl7.fhir.dstu2.model.Quantity in project beneficiary-fhir-data by CMSgov.
the class R4ExplanationOfBenefitResourceProviderIT method assertEobEquals.
/**
* Compares two ExplanationOfBenefit objects in detail while working around serialization issues
* like comparing "0" and "0.0" or creation differences like using "Quantity" vs "SimpleQuantity"
*
* @param expected the expected
* @param actual the actual
*/
private static void assertEobEquals(ExplanationOfBenefit expected, ExplanationOfBenefit actual) {
// ID in the bundle will have `ExplanationOfBenefit/` in front, so make sure the last bit
// matches up
assertTrue(actual.getId().endsWith(expected.getId()));
// Clean them out so we can do a deep compare later
actual.setId("");
expected.setId("");
// If there are any contained resources, they might have lastupdate times in them too
assertEquals(expected.getContained().size(), actual.getContained().size());
for (int i = 0; i < expected.getContained().size(); i++) {
Resource expectedContained = expected.getContained().get(i);
Resource actualContained = actual.getContained().get(i);
expectedContained.getMeta().setLastUpdated(null);
actualContained.getMeta().setLastUpdated(null);
// TODO: HAPI seems to be inserting the `#` in the ID of the contained element.
// This is incorrect according to the FHIR spec:
// https://build.fhir.org/references.html#contained
// This works around that problem
assertEquals("#" + expectedContained.getId(), actualContained.getId());
expectedContained.setId("");
actualContained.setId("");
}
// Dates are not easy to compare so just make sure they are there
assertNotNull(actual.getMeta().getLastUpdated());
// We compared all of meta that we care about so get it out of the way
expected.getMeta().setLastUpdated(null);
actual.getMeta().setLastUpdated(null);
// Created is required, but can't be compared
assertNotNull(actual.getCreated());
expected.setCreated(null);
actual.setCreated(null);
// Extensions may have `valueMoney` elements
assertEquals(expected.getExtension().size(), actual.getExtension().size());
for (int i = 0; i < expected.getExtension().size(); i++) {
Extension expectedEx = expected.getExtension().get(i);
Extension actualEx = actual.getExtension().get(i);
// We have to deal with Money objects separately
if (expectedEx.hasValue() && expectedEx.getValue() instanceof Money) {
assertTrue(actualEx.getValue() instanceof Money);
assertCurrencyEquals((Money) expectedEx.getValue(), (Money) actualEx.getValue());
// Now remove since we validated so we can compare the rest directly
expectedEx.setValue(null);
actualEx.setValue(null);
}
}
// SupportingInfo can have `valueQuantity` that has the 0 vs 0.0 issue
assertEquals(expected.getSupportingInfo().size(), actual.getSupportingInfo().size());
for (int i = 0; i < expected.getSupportingInfo().size(); i++) {
SupportingInformationComponent expectedSup = expected.getSupportingInfo().get(i);
SupportingInformationComponent actualSup = actual.getSupportingInfo().get(i);
// We have to deal with Money objects separately
if (expectedSup.hasValueQuantity()) {
assertTrue(actualSup.hasValueQuantity());
assertEquals(expectedSup.getValueQuantity().getValue().floatValue(), actualSup.getValueQuantity().getValue().floatValue(), 0.0);
// Now remove since we validated so we can compare the rest directly
expectedSup.setValue(null);
actualSup.setValue(null);
}
}
// line items
assertEquals(expected.getItem().size(), actual.getItem().size());
for (int i = 0; i < expected.getItem().size(); i++) {
ItemComponent expectedItem = expected.getItem().get(i);
ItemComponent actualItem = actual.getItem().get(i);
// Compare value directly because SimpleQuantity vs Quantity can't be compared
assertEquals(expectedItem.getQuantity().getValue().floatValue(), actualItem.getQuantity().getValue().floatValue(), 0.0);
expectedItem.setQuantity(null);
actualItem.setQuantity(null);
assertEquals(expectedItem.getAdjudication().size(), actualItem.getAdjudication().size());
for (int j = 0; j < expectedItem.getAdjudication().size(); j++) {
AdjudicationComponent expectedAdj = expectedItem.getAdjudication().get(j);
AdjudicationComponent actualAdj = actualItem.getAdjudication().get(j);
// Here is where we start getting into trouble with "0" vs "0.0", so we do this manually
if (expectedAdj.hasAmount()) {
assertNotNull(actualAdj.getAmount());
assertCurrencyEquals(expectedAdj.getAmount(), actualAdj.getAmount());
} else {
// If expected doesn't have an amount, actual shouldn't
assertFalse(actualAdj.hasAmount());
}
// We just checked manually, so null them out and check the rest of the fields
expectedAdj.setAmount(null);
actualAdj.setAmount(null);
}
}
// Total has the same problem with values
assertEquals(expected.getTotal().size(), actual.getTotal().size());
for (int i = 0; i < expected.getTotal().size(); i++) {
TotalComponent expectedTot = expected.getTotal().get(i);
TotalComponent actualTot = actual.getTotal().get(i);
if (expectedTot.hasAmount()) {
assertNotNull(actualTot.getAmount());
assertCurrencyEquals(expectedTot.getAmount(), actualTot.getAmount());
} else {
// If expected doesn't have an amount, actual shouldn't
assertFalse(actualTot.hasAmount());
}
expectedTot.setAmount(null);
actualTot.setAmount(null);
}
// Benefit Balance Financial components
assertEquals(expected.getBenefitBalance().size(), actual.getBenefitBalance().size());
for (int i = 0; i < expected.getBenefitBalance().size(); i++) {
BenefitBalanceComponent expectedBen = expected.getBenefitBalance().get(i);
BenefitBalanceComponent actualBen = actual.getBenefitBalance().get(i);
assertEquals(expectedBen.getFinancial().size(), actualBen.getFinancial().size());
for (int j = 0; j < expectedBen.getFinancial().size(); j++) {
BenefitComponent expectedFinancial = expectedBen.getFinancial().get(j);
BenefitComponent actualFinancial = actualBen.getFinancial().get(j);
// Are we dealing with Money?
if (expectedFinancial.hasUsedMoney()) {
assertNotNull(actualFinancial.getUsedMoney());
assertCurrencyEquals(expectedFinancial.getUsedMoney(), actualFinancial.getUsedMoney());
// Clean up
expectedFinancial.setUsed(null);
actualFinancial.setUsed(null);
}
}
}
// As does payment
if (expected.hasPayment()) {
assertTrue(actual.hasPayment());
assertCurrencyEquals(expected.getPayment().getAmount(), actual.getPayment().getAmount());
} else {
// If expected doesn't have an amount, actual shouldn't
assertFalse(actual.hasPayment());
}
expected.getPayment().setAmount(null);
actual.getPayment().setAmount(null);
// Now for the grand finale, we can do an `equalsDeep` on the rest
assertTrue(expected.equalsDeep(actual));
}
use of org.hl7.fhir.dstu2.model.Quantity in project beneficiary-fhir-data by CMSgov.
the class SNFClaimTransformerV2Test method shouldHaveLineItemQuantity.
@Test
public void shouldHaveLineItemQuantity() {
Quantity quantity = eob.getItemFirstRep().getQuantity();
Quantity compare = new Quantity(0);
assertTrue(compare.equalsDeep(quantity));
}
use of org.hl7.fhir.dstu2.model.Quantity in project beneficiary-fhir-data by CMSgov.
the class SNFClaimTransformerV2Test method shouldHaveNchBloodPntsFrnshdQtySupInfo.
@Test
public void shouldHaveNchBloodPntsFrnshdQtySupInfo() {
SupportingInformationComponent sic = TransformerTestUtilsV2.findSupportingInfoByCode("https://bluebutton.cms.gov/resources/variables/nch_blood_pnts_frnshd_qty", eob.getSupportingInfo());
SupportingInformationComponent compare = TransformerTestUtilsV2.createSupportingInfo(// We don't care what the sequence number is here
sic.getSequence(), // Category
Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/claiminformationcategory", "info", "Information"), new Coding("https://bluebutton.cms.gov/resources/codesystem/information", "https://bluebutton.cms.gov/resources/variables/nch_blood_pnts_frnshd_qty", "NCH Blood Pints Furnished Quantity"))).setValue(new Quantity().setValue(19).setUnit("pint").setSystem("http://unitsofmeasure.org").setCode("[pt_us]"));
assertTrue(compare.equalsDeep(sic));
}
use of org.hl7.fhir.dstu2.model.Quantity in project beneficiary-fhir-data by CMSgov.
the class PartDEventTransformerV2Test method shouldHaveLineItemQuantity.
@Test
public void shouldHaveLineItemQuantity() {
Quantity quantity = eob.getItemFirstRep().getQuantity();
Quantity compare = new Quantity(60);
assertTrue(compare.equalsDeep(quantity));
}
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