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Example 16 with Resource

use of org.hl7.fhir.dstu2016may.model.Resource in project beneficiary-fhir-data by CMSgov.

the class FissClaimResponseTransformerV2 method transformClaim.

/**
 * @param claimGroup the {@link PreAdjFissClaim} to transform
 * @return a FHIR {@link ClaimResponse} resource that represents the specified {@link
 *     PreAdjFissClaim}
 */
private static ClaimResponse transformClaim(PreAdjFissClaim claimGroup) {
    ClaimResponse claim = new ClaimResponse();
    claim.setId("f-" + claimGroup.getDcn());
    claim.setContained(List.of(getContainedPatient(claimGroup)));
    claim.setExtension(getExtension(claimGroup));
    claim.setIdentifier(getIdentifier(claimGroup));
    claim.setStatus(ClaimResponse.ClaimResponseStatus.ACTIVE);
    claim.setOutcome(STATUS_TO_OUTCOME.get(Character.toLowerCase(claimGroup.getCurrStatus())));
    claim.setType(getType());
    claim.setUse(ClaimResponse.Use.CLAIM);
    claim.setInsurer(new Reference().setIdentifier(new Identifier().setValue("CMS")));
    claim.setPatient(new Reference("#patient"));
    claim.setRequest(new Reference(String.format("Claim/f-%s", claimGroup.getDcn())));
    claim.setMeta(new Meta().setLastUpdated(Date.from(claimGroup.getLastUpdated())));
    claim.setCreated(new Date());
    return claim;
}
Also used : Meta(org.hl7.fhir.r4.model.Meta) Identifier(org.hl7.fhir.r4.model.Identifier) ClaimResponse(org.hl7.fhir.r4.model.ClaimResponse) Reference(org.hl7.fhir.r4.model.Reference) Date(java.util.Date)

Example 17 with Resource

use of org.hl7.fhir.dstu2016may.model.Resource in project beneficiary-fhir-data by CMSgov.

the class FissClaimTransformerV2 method getContainedProvider.

private static Resource getContainedProvider(PreAdjFissClaim claimGroup) {
    Organization organization = new Organization();
    if (claimGroup.getMedaProv_6() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBOrganizationIdentifierType.PRN.getSystem(), C4BBOrganizationIdentifierType.PRN.toCode(), C4BBOrganizationIdentifierType.PRN.getDisplay()))).setSystem(BBCodingSystems.PROVIDER_NUM).setValue(claimGroup.getMedaProv_6()));
    }
    if (claimGroup.getFedTaxNumber() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBOrganizationIdentifierType.TAX.getSystem(), C4BBOrganizationIdentifierType.TAX.toCode(), C4BBOrganizationIdentifierType.TAX.getDisplay()))).setSystem(BBCodingSystems.FISS.TAX_NUM).setValue(claimGroup.getFedTaxNumber()));
    }
    if (claimGroup.getNpiNumber() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBIdentifierType.NPI.getSystem(), C4BBIdentifierType.NPI.toCode(), C4BBIdentifierType.NPI.getDisplay()))).setSystem(TransformerConstants.CODING_NPI_US).setValue(claimGroup.getNpiNumber()));
    }
    organization.setId("provider-org");
    return organization;
}
Also used : Organization(org.hl7.fhir.r4.model.Organization) Identifier(org.hl7.fhir.r4.model.Identifier) Coding(org.hl7.fhir.r4.model.Coding) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept)

Example 18 with Resource

use of org.hl7.fhir.dstu2016may.model.Resource in project beneficiary-fhir-data by CMSgov.

the class FissClaimTransformerV2 method transformClaim.

/**
 * @param claimGroup the {@link PreAdjFissClaim} to transform
 * @return a FHIR {@link Claim} resource that represents the specified {@link PreAdjFissClaim}
 */
private static Claim transformClaim(PreAdjFissClaim claimGroup) {
    Claim claim = new Claim();
    boolean isIcd9 = claimGroup.getStmtCovToDate() != null && claimGroup.getStmtCovToDate().isBefore(ICD_9_CUTOFF_DATE);
    claim.setId("f-" + claimGroup.getDcn());
    claim.setContained(List.of(getContainedPatient(claimGroup), getContainedProvider(claimGroup)));
    claim.setIdentifier(getIdentifier(claimGroup));
    claim.setExtension(getExtension(claimGroup));
    claim.setStatus(Claim.ClaimStatus.ACTIVE);
    claim.setType(getType(claimGroup));
    claim.setSupportingInfo(getSupportingInfo(claimGroup));
    claim.setBillablePeriod(getBillablePeriod(claimGroup));
    claim.setUse(Claim.Use.CLAIM);
    claim.setPriority(getPriority());
    claim.setTotal(getTotal(claimGroup));
    claim.setProvider(new Reference("#provider-org"));
    claim.setPatient(new Reference("#patient"));
    claim.setFacility(getFacility(claimGroup));
    claim.setDiagnosis(getDiagnosis(claimGroup, isIcd9));
    claim.setProcedure(getProcedure(claimGroup, isIcd9));
    claim.setInsurance(getInsurance(claimGroup));
    claim.setMeta(new Meta().setLastUpdated(Date.from(claimGroup.getLastUpdated())));
    claim.setCreated(new Date());
    return claim;
}
Also used : Meta(org.hl7.fhir.r4.model.Meta) Reference(org.hl7.fhir.r4.model.Reference) PreAdjFissClaim(gov.cms.bfd.model.rda.PreAdjFissClaim) Claim(org.hl7.fhir.r4.model.Claim) Date(java.util.Date) LocalDate(java.time.LocalDate)

Example 19 with Resource

use of org.hl7.fhir.dstu2016may.model.Resource in project beneficiary-fhir-data by CMSgov.

the class McsClaimTransformerV2 method getContainedProvider.

private static Resource getContainedProvider(PreAdjMcsClaim claimGroup) {
    Organization organization = new Organization();
    if (claimGroup.getIdrBillProvType() != null) {
        organization.getExtension().add(new Extension(BBCodingSystems.MCS.BILL_PROV_TYPE).setValue(new Coding(BBCodingSystems.MCS.BILL_PROV_TYPE, claimGroup.getIdrBillProvType(), null)));
    }
    if (claimGroup.getIdrBillProvSpec() != null) {
        organization.getExtension().add(new Extension(BBCodingSystems.MCS.BILL_PROV_SPEC).setValue(new Coding(BBCodingSystems.MCS.BILL_PROV_SPEC, claimGroup.getIdrBillProvSpec(), null)));
    }
    if (claimGroup.getIdrBillProvEin() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBOrganizationIdentifierType.TAX.getSystem(), C4BBOrganizationIdentifierType.TAX.toCode(), C4BBOrganizationIdentifierType.TAX.getDisplay()))).setSystem(BBCodingSystems.MCS.BILL_PROV_EIN).setValue(claimGroup.getIdrBillProvEin()));
    }
    if (claimGroup.getIdrBillProvNum() != null) {
        organization.getIdentifier().add(new Identifier().setType(new CodeableConcept(new Coding(C4BBIdentifierType.NPI.getSystem(), C4BBIdentifierType.NPI.toCode(), C4BBIdentifierType.NPI.getDisplay()))).setSystem(TransformerConstants.CODING_NPI_US).setValue(claimGroup.getIdrBillProvNpi()));
    }
    organization.setId("provider-org");
    return organization;
}
Also used : Extension(org.hl7.fhir.r4.model.Extension) Organization(org.hl7.fhir.r4.model.Organization) Identifier(org.hl7.fhir.r4.model.Identifier) Coding(org.hl7.fhir.r4.model.Coding) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept)

Example 20 with Resource

use of org.hl7.fhir.dstu2016may.model.Resource in project beneficiary-fhir-data by CMSgov.

the class HHAClaimTransformerV2Test method shouldHaveLineItemRevenue.

@Test
public void shouldHaveLineItemRevenue() {
    CodeableConcept revenue = eob.getItemFirstRep().getRevenue();
    Coding code1 = revenue.getCoding().stream().filter(coding -> coding.getSystem().equals("https://bluebutton.cms.gov/resources/variables/rev_cntr")).findFirst().orElse(null);
    Coding code2 = revenue.getCoding().stream().filter(coding -> coding.getSystem().equals("https://www.nubc.org/CodeSystem/RevenueCodes")).findFirst().orElse(null);
    Coding code3 = revenue.getCoding().stream().filter(coding -> coding.getSystem().equals("https://bluebutton.cms.gov/resources/variables/rev_cntr_ddctbl_coinsrnc_cd")).findFirst().orElse(null);
    assertNotNull(code1, "Missing expected rev_cntr coding");
    assertEquals("0023", code1.getCode());
    assertEquals("Home Health services paid under PPS submitted as TOB 32X and 33X, effective 10/00. This code may appear multiple times on a claim to identify different HIPPS/Home Health Resource Groups (HRG).", code1.getDisplay());
    assertNotNull(code2, "Missing expected RevenueCodes coding");
    assertEquals("4", code2.getCode());
    assertNull(code2.getDisplay());
    assertNotNull(code3, "Missing expected rev_cntr_ddctbl_coinsrnc_cd coding");
    assertEquals("4", code3.getCode());
    assertEquals("No charge or units associated with this revenue center code. (For multiple HCPCS per single revenue center code) For revenue center code 0001, the following MSP override values may be present:", code3.getDisplay());
}
Also used : Coding(org.hl7.fhir.r4.model.Coding) CodeableConcept(org.hl7.fhir.r4.model.CodeableConcept) Test(org.junit.jupiter.api.Test)

Aggregations

ArrayList (java.util.ArrayList)319 Resource (org.hl7.fhir.r4.model.Resource)312 Test (org.junit.jupiter.api.Test)297 IBaseResource (org.hl7.fhir.instance.model.api.IBaseResource)270 BundleEntryComponent (org.hl7.fhir.r4.model.Bundle.BundleEntryComponent)230 FHIRException (org.hl7.fhir.exceptions.FHIRException)201 Test (org.junit.Test)190 IOException (java.io.IOException)181 Bundle (org.hl7.fhir.r4.model.Bundle)169 Date (java.util.Date)147 ParameterizedTest (org.junit.jupiter.params.ParameterizedTest)139 List (java.util.List)133 HashMap (java.util.HashMap)131 Patient (org.hl7.fhir.r4.model.Patient)118 FileOutputStream (java.io.FileOutputStream)110 Reference (org.hl7.fhir.r4.model.Reference)109 IGenericClient (ca.uhn.fhir.rest.client.api.IGenericClient)102 File (java.io.File)100 Collectors (java.util.stream.Collectors)95 XhtmlNode (org.hl7.fhir.utilities.xhtml.XhtmlNode)92