Examples with AdjudicationComponent org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent used on opensource projects

Example 1 with AdjudicationComponent

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent in project beneficiary-fhir-data by CMSgov.

the class TransformerUtils method createAdjudicationCategory.

/**
 * @param ccwVariable the {@link CcwCodebookInterface} being mapped
 * @return the {@link AdjudicationComponent#getCategory()} {@link CodeableConcept} to use for the
 *     specified {@link CcwCodebookInterface}
 */
static CodeableConcept createAdjudicationCategory(CcwCodebookInterface ccwVariable) {
    /*
     * Adjudication.category is mapped a bit differently than other Codings/CodeableConcepts: they
     * all share the same Coding.system and use the CcwCodebookVariable reference URL as their
     * Coding.code. This looks weird, but makes it easy for API developers to find more information
     * about what the specific adjudication they're looking at means.
     */
    String conceptCode = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
    CodeableConcept categoryConcept = createCodeableConcept(TransformerConstants.CODING_CCW_ADJUDICATION_CATEGORY, conceptCode);
    categoryConcept.getCodingFirstRep().setDisplay(ccwVariable.getVariable().getLabel());
    return categoryConcept;
}

Example 2 with AdjudicationComponent

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent in project beneficiary-fhir-data by CMSgov.

the class TransformerUtilsV2 method createAdjudicationCategory.

/**
 * @param ccwVariable the {@link CcwCodebookInterface} being mapped
 * @return the {@link AdjudicationComponent#getCategory()} {@link CodeableConcept} to use for the
 *     specified {@link CcwCodebookInterface}
 */
static CodeableConcept createAdjudicationCategory(CcwCodebookInterface ccwVariable, String carinAdjuCode, String carinAdjuCodeDisplay) {
    /*
     * Adjudication.category is mapped a bit differently than other Codings/CodeableConcepts: they
     * all share the same Coding.system and use the CcwCodebookInterface reference URL as their
     * Coding.code. This looks weird, but makes it easy for API developers to find more information
     * about what the specific adjudication they're looking at means.
     */
    String conceptCode = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
    CodeableConcept categoryConcept = createCodeableConcept(TransformerConstants.CODING_CCW_ADJUDICATION_CATEGORY, conceptCode);
    categoryConcept.getCodingFirstRep().setDisplay(ccwVariable.getVariable().getLabel());
    categoryConcept.addCoding().setSystem(C4BBAdjudication.SUBMITTED.getSystem()).setCode(carinAdjuCode).setDisplay(carinAdjuCodeDisplay);
    return categoryConcept;
}

Example 3 with AdjudicationComponent

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent in project beneficiary-fhir-data by CMSgov.

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntrPrvdrPmtAmt.

@Test
public void shouldHaveLineItemAdjudicationRevCntrPrvdrPmtAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_prvdr_pmt_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", "paidtoprovider", "Paid to provider"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_prvdr_pmt_amt", "Revenue Center (Medicare) Provider Payment Amount")))).setAmount(new Money().setValue(200).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 4 with AdjudicationComponent

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent in project beneficiary-fhir-data by CMSgov.

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntrCoinsrncWgeAdjstdC.

@Test
public void shouldHaveLineItemAdjudicationRevCntrCoinsrncWgeAdjstdC() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_coinsrnc_wge_adjstd_c", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", "coinsurance", "Co-insurance"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_coinsrnc_wge_adjstd_c", "Revenue Center Coinsurance/Wage Adjusted Coinsurance Amount")))).setAmount(new Money().setValue(15.23).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}

Example 5 with AdjudicationComponent

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.AdjudicationComponent in project beneficiary-fhir-data by CMSgov.

the class OutpatientClaimTransformerV2Test method shouldHaveLineItemAdjudicationRevCntrCashDdctblAmt.

@Test
public void shouldHaveLineItemAdjudicationRevCntrCashDdctblAmt() {
    AdjudicationComponent adjudication = TransformerTestUtilsV2.findAdjudicationByCategory("https://bluebutton.cms.gov/resources/variables/rev_cntr_cash_ddctbl_amt", eob.getItemFirstRep().getAdjudication());
    AdjudicationComponent compare = new AdjudicationComponent().setCategory(new CodeableConcept().setCoding(Arrays.asList(new Coding("http://terminology.hl7.org/CodeSystem/adjudication", "deductible", "Deductible"), new Coding("https://bluebutton.cms.gov/resources/codesystem/adjudication", "https://bluebutton.cms.gov/resources/variables/rev_cntr_cash_ddctbl_amt", "Revenue Center Cash Deductible Amount")))).setAmount(new Money().setValue(12.89).setCurrency(TransformerConstants.CODED_MONEY_USD));
    assertTrue(compare.equalsDeep(adjudication));
}