use of org.hl7.fhir.dstu3.model.ExplanationOfBenefit.SupportingInformationComponent in project beneficiary-fhir-data by CMSgov.
the class PartDEventTransformerV2Test method shouldHaveDAWProdSlctnCdCodeSupInfo.
@Test
public void shouldHaveDAWProdSlctnCdCodeSupInfo() {
SupportingInformationComponent sic = TransformerTestUtilsV2.findSupportingInfoByCode("https://bluebutton.cms.gov/resources/variables/daw_prod_slctn_cd", 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/daw_prod_slctn_cd", "Dispense as Written (DAW) Product Selection Code")), // Code
new Coding("https://bluebutton.cms.gov/resources/variables/daw_prod_slctn_cd", "0", "No Product Selection Indicated (may also have missing values)"));
assertTrue(compare.equalsDeep(sic));
}
use of org.hl7.fhir.dstu3.model.ExplanationOfBenefit.SupportingInformationComponent in project beneficiary-fhir-data by CMSgov.
the class PartDEventTransformerV2Test method shouldHaveAdjstmtDltnCdSupInfo.
@Test
public void shouldHaveAdjstmtDltnCdSupInfo() {
SupportingInformationComponent sic = TransformerTestUtilsV2.findSupportingInfoByCode("https://bluebutton.cms.gov/resources/variables/adjstmt_dltn_cd", 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/adjstmt_dltn_cd", "Adjustment Deletion Code")), // Code
new Coding("https://bluebutton.cms.gov/resources/variables/adjstmt_dltn_cd", "A", "Adjustment"));
assertTrue(compare.equalsDeep(sic));
}
use of org.hl7.fhir.dstu3.model.ExplanationOfBenefit.SupportingInformationComponent in project synthea by synthetichealth.
the class FhirR4 method encounterClaim.
/**
* Create an entry for the given Claim, associated to an Encounter.
*
* @param person The patient having the encounter.
* @param personEntry Entry for the person
* @param bundle The Bundle to add to
* @param encounterEntry The current Encounter
* @param claim the Claim object
* @return the added Entry
*/
private static BundleEntryComponent encounterClaim(Person person, BundleEntryComponent personEntry, Bundle bundle, BundleEntryComponent encounterEntry, Claim claim) {
org.hl7.fhir.r4.model.Claim claimResource = new org.hl7.fhir.r4.model.Claim();
org.hl7.fhir.r4.model.Encounter encounterResource = (org.hl7.fhir.r4.model.Encounter) encounterEntry.getResource();
claimResource.setStatus(ClaimStatus.ACTIVE);
CodeableConcept type = new CodeableConcept();
type.getCodingFirstRep().setSystem("http://terminology.hl7.org/CodeSystem/claim-type").setCode("institutional");
claimResource.setType(type);
claimResource.setUse(org.hl7.fhir.r4.model.Claim.Use.CLAIM);
InsuranceComponent insuranceComponent = new InsuranceComponent();
insuranceComponent.setSequence(1);
insuranceComponent.setFocal(true);
insuranceComponent.setCoverage(new Reference().setDisplay(claim.payer.getName()));
claimResource.addInsurance(insuranceComponent);
// duration of encounter
claimResource.setBillablePeriod(encounterResource.getPeriod());
claimResource.setCreated(encounterResource.getPeriod().getEnd());
claimResource.setPatient(new Reference().setReference(personEntry.getFullUrl()).setDisplay((String) person.attributes.get(Person.NAME)));
claimResource.setProvider(encounterResource.getServiceProvider());
if (USE_US_CORE_IG) {
claimResource.setFacility(encounterResource.getLocationFirstRep().getLocation());
}
// set the required priority
CodeableConcept priority = new CodeableConcept();
priority.getCodingFirstRep().setSystem("http://terminology.hl7.org/CodeSystem/processpriority").setCode("normal");
claimResource.setPriority(priority);
// add item for encounter
claimResource.addItem(new ItemComponent(new PositiveIntType(1), encounterResource.getTypeFirstRep()).addEncounter(new Reference(encounterEntry.getFullUrl())));
int itemSequence = 2;
int conditionSequence = 1;
int procedureSequence = 1;
int informationSequence = 1;
for (Claim.ClaimEntry claimEntry : claim.items) {
HealthRecord.Entry item = claimEntry.entry;
if (Costs.hasCost(item)) {
// update claimItems list
Code primaryCode = item.codes.get(0);
String system = ExportHelper.getSystemURI(primaryCode.system);
ItemComponent claimItem = new ItemComponent(new PositiveIntType(itemSequence), mapCodeToCodeableConcept(primaryCode, system));
// calculate the cost of the procedure
Money moneyResource = new Money();
moneyResource.setCurrency("USD");
moneyResource.setValue(item.getCost());
claimItem.setNet(moneyResource);
claimResource.addItem(claimItem);
if (item instanceof Procedure) {
Type procedureReference = new Reference(item.fullUrl);
ProcedureComponent claimProcedure = new ProcedureComponent(new PositiveIntType(procedureSequence), procedureReference);
claimResource.addProcedure(claimProcedure);
claimItem.addProcedureSequence(procedureSequence);
procedureSequence++;
} else {
Reference informationReference = new Reference(item.fullUrl);
SupportingInformationComponent informationComponent = new SupportingInformationComponent();
informationComponent.setSequence(informationSequence);
informationComponent.setValue(informationReference);
CodeableConcept category = new CodeableConcept();
category.getCodingFirstRep().setSystem("http://terminology.hl7.org/CodeSystem/claiminformationcategory").setCode("info");
informationComponent.setCategory(category);
claimResource.addSupportingInfo(informationComponent);
claimItem.addInformationSequence(informationSequence);
informationSequence++;
}
} else {
// assume it's a Condition, we don't have a Condition class specifically
// add diagnosisComponent to claim
Reference diagnosisReference = new Reference(item.fullUrl);
DiagnosisComponent diagnosisComponent = new DiagnosisComponent(new PositiveIntType(conditionSequence), diagnosisReference);
claimResource.addDiagnosis(diagnosisComponent);
// update claimItems with diagnosis
ItemComponent diagnosisItem = new ItemComponent(new PositiveIntType(itemSequence), mapCodeToCodeableConcept(item.codes.get(0), SNOMED_URI));
diagnosisItem.addDiagnosisSequence(conditionSequence);
claimResource.addItem(diagnosisItem);
conditionSequence++;
}
itemSequence++;
}
Money moneyResource = new Money();
moneyResource.setCurrency("USD");
moneyResource.setValue(claim.getTotalClaimCost());
claimResource.setTotal(moneyResource);
return newEntry(person, bundle, claimResource);
}
use of org.hl7.fhir.dstu3.model.ExplanationOfBenefit.SupportingInformationComponent 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;
}
use of org.hl7.fhir.dstu3.model.ExplanationOfBenefit.SupportingInformationComponent in project beneficiary-fhir-data by CMSgov.
the class TransformerUtils method addCommonGroupInpatientSNF.
/**
* Adds field values to the benefit balance component that are common between the Inpatient and
* SNF claim types.
*
* @param eob the {@link ExplanationOfBenefit} to map the fields into
* @param coinsuranceDayCount BENE_TOT_COINSRNC_DAYS_CNT: a {@link BigDecimal} shared field
* representing the coinsurance day count for the claim
* @param nonUtilizationDayCount CLM_NON_UTLZTN_DAYS_CNT: a {@link BigDecimal} shared field
* representing the non-utilization day count for the claim
* @param deductibleAmount NCH_BENE_IP_DDCTBL_AMT: a {@link BigDecimal} shared field representing
* the deductible amount for the claim
* @param partACoinsuranceLiabilityAmount NCH_BENE_PTA_COINSRNC_LBLTY_AM: a {@link BigDecimal}
* shared field representing the part A coinsurance amount for the claim
* @param bloodPintsFurnishedQty NCH_BLOOD_PNTS_FRNSHD_QTY: a {@link BigDecimal} shared field
* representing the blood pints furnished quantity for the claim
* @param noncoveredCharge NCH_IP_NCVRD_CHRG_AMT: a {@link BigDecimal} shared field representing
* the non-covered charge for the claim
* @param totalDeductionAmount NCH_IP_TOT_DDCTN_AMT: a {@link BigDecimal} shared field
* representing the total deduction amount for the claim
* @param claimPPSCapitalDisproportionateShareAmt CLM_PPS_CPTL_DSPRPRTNT_SHR_AMT: an {@link
* Optional}<{@link BigDecimal}> shared field representing the claim PPS capital
* disproportionate share amount for the claim
* @param claimPPSCapitalExceptionAmount CLM_PPS_CPTL_EXCPTN_AMT: an {@link Optional}<{@link
* BigDecimal}> shared field representing the claim PPS capital exception amount for the
* claim
* @param claimPPSCapitalFSPAmount CLM_PPS_CPTL_FSP_AMT: an {@link Optional}<{@link
* BigDecimal}> shared field representing the claim PPS capital FSP amount for the claim
* @param claimPPSCapitalIMEAmount CLM_PPS_CPTL_IME_AMT: an {@link Optional}<{@link
* BigDecimal}> shared field representing the claim PPS capital IME amount for the claim
* @param claimPPSCapitalOutlierAmount CLM_PPS_CPTL_OUTLIER_AMT: an {@link Optional}<{@link
* BigDecimal}> shared field representing the claim PPS capital outlier amount for the
* claim
* @param claimPPSOldCapitalHoldHarmlessAmount CLM_PPS_OLD_CPTL_HLD_HRMLS_AMT: an {@link
* Optional}<{@link BigDecimal}> shared field representing the claim PPS old capital
* hold harmless amount for the claim
*/
static void addCommonGroupInpatientSNF(ExplanationOfBenefit eob, BigDecimal coinsuranceDayCount, BigDecimal nonUtilizationDayCount, BigDecimal deductibleAmount, BigDecimal partACoinsuranceLiabilityAmount, BigDecimal bloodPintsFurnishedQty, BigDecimal noncoveredCharge, BigDecimal totalDeductionAmount, Optional<BigDecimal> claimPPSCapitalDisproportionateShareAmt, Optional<BigDecimal> claimPPSCapitalExceptionAmount, Optional<BigDecimal> claimPPSCapitalFSPAmount, Optional<BigDecimal> claimPPSCapitalIMEAmount, Optional<BigDecimal> claimPPSCapitalOutlierAmount, Optional<BigDecimal> claimPPSOldCapitalHoldHarmlessAmount) {
BenefitComponent beneTotCoinsrncDaysCntFinancial = addBenefitBalanceFinancial(eob, BenefitCategory.MEDICAL, CcwCodebookVariable.BENE_TOT_COINSRNC_DAYS_CNT);
beneTotCoinsrncDaysCntFinancial.setUsed(new UnsignedIntType(coinsuranceDayCount.intValueExact()));
BenefitComponent clmNonUtlztnDaysCntFinancial = addBenefitBalanceFinancial(eob, BenefitCategory.MEDICAL, CcwCodebookVariable.CLM_NON_UTLZTN_DAYS_CNT);
clmNonUtlztnDaysCntFinancial.setUsed(new UnsignedIntType(nonUtilizationDayCount.intValueExact()));
addAdjudicationTotal(eob, CcwCodebookVariable.NCH_BENE_IP_DDCTBL_AMT, deductibleAmount);
addAdjudicationTotal(eob, CcwCodebookVariable.NCH_BENE_PTA_COINSRNC_LBLTY_AMT, partACoinsuranceLiabilityAmount);
SupportingInformationComponent nchBloodPntsFrnshdQtyInfo = addInformation(eob, CcwCodebookVariable.NCH_BLOOD_PNTS_FRNSHD_QTY);
Quantity bloodPintsQuantity = new Quantity();
bloodPintsQuantity.setValue(bloodPintsFurnishedQty);
bloodPintsQuantity.setSystem(TransformerConstants.CODING_SYSTEM_UCUM).setCode(TransformerConstants.CODING_SYSTEM_UCUM_PINT_CODE).setUnit(TransformerConstants.CODING_SYSTEM_UCUM_PINT_DISPLAY);
nchBloodPntsFrnshdQtyInfo.setValue(bloodPintsQuantity);
addAdjudicationTotal(eob, CcwCodebookVariable.NCH_IP_NCVRD_CHRG_AMT, noncoveredCharge);
addAdjudicationTotal(eob, CcwCodebookVariable.NCH_IP_TOT_DDCTN_AMT, totalDeductionAmount);
if (claimPPSCapitalDisproportionateShareAmt.isPresent()) {
addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PPS_CPTL_DSPRPRTNT_SHR_AMT, claimPPSCapitalDisproportionateShareAmt);
}
if (claimPPSCapitalExceptionAmount.isPresent()) {
addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PPS_CPTL_EXCPTN_AMT, claimPPSCapitalExceptionAmount);
}
if (claimPPSCapitalFSPAmount.isPresent()) {
addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PPS_CPTL_FSP_AMT, claimPPSCapitalFSPAmount);
}
if (claimPPSCapitalIMEAmount.isPresent()) {
addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PPS_CPTL_IME_AMT, claimPPSCapitalIMEAmount);
}
if (claimPPSCapitalOutlierAmount.isPresent()) {
addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PPS_CPTL_OUTLIER_AMT, claimPPSCapitalOutlierAmount);
}
if (claimPPSOldCapitalHoldHarmlessAmount.isPresent()) {
addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PPS_OLD_CPTL_HLD_HRMLS_AMT, claimPPSOldCapitalHoldHarmlessAmount);
}
}
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