Example 1 with Device
use of org.mitre.synthea.world.concepts.HealthRecord.Device in project synthea by synthetichealth.
the class CPCDSExporter method claim.
/**
* Method to write a single Claims file. Take an encounter in the parameters and
* processes Diagnoses, Procedures, and Pharmacy claims for each one, in order.
*
* @param rand Source of randomness to use when generating ids etc
* @param encounter The encounter object itself
* @param personID The Id of the involved patient
* @param encounterID The Id of the encounter
* @param medRecordNumber The patients Medical Record Number
* @param attributes Calculated attributes for the entire encounter
* @param payerId The Id of the payer
* @throws IOException Throws this exception
*/
private void claim(RandomNumberGenerator rand, Encounter encounter, String personID, String encounterID, UUID medRecordNumber, CPCDSAttributes attributes, String payerId, String coverageID) throws IOException {
StringBuilder s = new StringBuilder();
int i = 1;
while (i <= attributes.getLength()) {
// admin
String billType = attributes.getBillTypeCode();
String[] adminSection = { String.valueOf(dateFromTimestamp(encounter.start)), String.valueOf(dateFromTimestamp(encounter.stop)), String.valueOf(dateFromTimestamp(encounter.stop)), String.valueOf(dateFromTimestamp(encounter.start)), String.valueOf(dateFromTimestamp(encounter.start)), String.valueOf(dateFromTimestamp(encounter.stop)), personID.toString(), medRecordNumber.toString(), encounterID, "", "", "", attributes.getSourceAdminCode(), attributes.getAdmissionTypeCode(), Character.toString(billType.charAt(0)), Character.toString(billType.charAt(1)), Character.toString(billType.charAt(2)), attributes.getProcStatus(), attributes.getClaimType(), attributes.getDischarge(), attributes.getDenialCode(), coverageID, attributes.getPayeeType(), personID, attributes.getPaymentType(), coverageID };
StringBuilder admin = new StringBuilder();
for (String item : adminSection) {
admin.append(item).append(',');
}
String adminString = admin.toString();
// provider
practitioner(encounter.clinician.attributes.get("specialty").toString(), attributes.getNpiProvider(), attributes.getServiceSiteNPI(), encounter.clinician.getFullname());
String[] providerSection = { attributes.getNpiProvider(), attributes.getNetworkStatus(), attributes.getNpiProvider(), attributes.getNetworkStatus(), attributes.getServiceSiteNPI(), attributes.getNetworkStatus(), attributes.getNpiProvider(), attributes.getNetworkStatus(), attributes.getNpiProvider(), attributes.getNetworkStatus(), attributes.getNpiPrescribingProvider(), attributes.getNetworkStatus(), attributes.getNpiProvider() };
StringBuilder provider = new StringBuilder();
for (String item : providerSection) {
provider.append(item).append(',');
}
String providerString = provider.toString();
// totals
// encounter.claim.getTotalClaimCost();
BigDecimal totalCost = attributes.getTotalClaimCost();
BigDecimal coveredCost = encounter.claim.getCoveredCost();
BigDecimal disallowed = totalCost.subtract(coveredCost);
BigDecimal patientPaid = Claim.ZERO_CENTS;
BigDecimal memberReimbursement = Claim.ZERO_CENTS;
BigDecimal paymentAmount = Claim.ZERO_CENTS;
BigDecimal toProvider = Claim.ZERO_CENTS;
BigDecimal deductible = encounter.claim.person.coverage.getTotalCoverage();
BigDecimal liability = Claim.ZERO_CENTS;
BigDecimal copay = Claim.ZERO_CENTS;
if (disallowed.compareTo(Claim.ZERO_CENTS) > 0) {
memberReimbursement = Claim.ZERO_CENTS;
patientPaid = disallowed;
} else {
memberReimbursement = disallowed.negate();
disallowed = Claim.ZERO_CENTS;
patientPaid = Claim.ZERO_CENTS;
}
paymentAmount = coveredCost.add(patientPaid);
toProvider = paymentAmount;
liability = totalCost.subtract(paymentAmount);
String[] claimTotalsSection = { String.valueOf(paymentAmount), String.valueOf(totalCost), String.valueOf(patientPaid), String.valueOf(toProvider), String.valueOf(memberReimbursement), String.valueOf(paymentAmount), String.valueOf(disallowed), String.valueOf(deductible), String.valueOf(""), String.valueOf(copay), String.valueOf(liability), String.valueOf(coveredCost), String.valueOf(0.00) };
StringBuilder totals = new StringBuilder();
for (String item : claimTotalsSection) {
totals.append(item).append(',');
}
String totalsString = totals.toString();
String pharmacyEMPTY = ",,,,,,," + attributes.getResidence() + ",";
String procedureEMPTY = ",,,,,,,,";
// diagnosis
for (Entry condition : encounter.conditions) {
StringBuilder cond = new StringBuilder();
String presentOnAdmission;
String[] poaCodes = { "Y", "N", "U", "W" };
presentOnAdmission = poaCodes[(int) randomLongWithBounds(0, 3)];
cond.append(adminString);
cond.append(pharmacyEMPTY);
cond.append(providerString);
cond.append(totalsString);
cond.append(dateFromTimestamp(condition.start)).append(',');
cond.append(i).append(',');
cond.append(dateFromTimestamp(condition.stop)).append(',');
cond.append("").append(',');
cond.append(attributes.getPlaceOfService()).append(',');
cond.append(attributes.getRevenueCenterCode()).append(',');
cond.append("").append(',');
cond.append("").append(',');
cond.append("").append(',');
cond.append("").append(',');
cond.append("").append(',');
cond.append("").append(',');
cond.append(attributes.getBenefitPaymentStatus()).append(',');
cond.append(attributes.getDenialCode()).append(',');
BigDecimal cost = condition.getCost();
cond.append(0.00).append(',');
cond.append(0.00).append(',');
cond.append(0.00).append(',');
cond.append("").append(',');
cond.append(cost).append(',');
cond.append(cost).append(',');
cond.append(encounter.claim.person.coverage.getTotalCoverage()).append(',');
cond.append(cost).append(',');
cond.append(0.00).append(',');
cond.append(cost).append(',');
cond.append(cost).append(',');
cond.append(0.00).append(',');
cond.append(0.00).append(',');
cond.append(0.00).append(',');
Code coding = condition.codes.get(0);
String diagnosisCode = "SNOMED";
String diagnosisType = "principal";
cond.append(coding.code).append(',');
cond.append(clean(coding.display)).append(',');
cond.append(presentOnAdmission).append(',');
cond.append(diagnosisCode).append(',');
cond.append(diagnosisType).append(',');
cond.append("").append(',');
cond.append(procedureEMPTY).append(NEWLINE);
s.append(cond.toString());
i++;
}
// procedures
int k = 0;
for (Procedure procedure : encounter.procedures) {
String presentOnAdmission;
String diagnosisCode = "SNOMED";
String diagnosisType = "principal";
String procedureType;
if (k == 0) {
procedureType = "primary";
} else {
procedureType = "secondary";
}
String[] poaCodes = { "Y", "N", "U", "W" };
presentOnAdmission = poaCodes[(int) randomLongWithBounds(0, 3)];
StringBuilder proc = new StringBuilder();
proc.append(adminString);
proc.append(",").append(",").append(",").append(",").append(",").append(",");
proc.append("01,").append(attributes.getResidence()).append(',');
proc.append(providerString);
proc.append(totalsString);
String typeOfService = "01";
if (attributes.getNetworkStatus().equals("out")) {
typeOfService = "11";
}
proc.append(dateFromTimestamp(procedure.start)).append(',');
proc.append(i).append(',');
proc.append(dateFromTimestamp(procedure.stop)).append(',');
proc.append(typeOfService).append(',');
proc.append(attributes.getPlaceOfService()).append(',');
proc.append(attributes.getRevenueCenterCode()).append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append(attributes.getBenefitPaymentStatus()).append(',');
proc.append(attributes.getDenialCode()).append(',');
BigDecimal cost = procedure.getCost();
proc.append(0.00).append(',');
proc.append(0.00).append(',');
proc.append(0.00).append(',');
proc.append("").append(',');
proc.append(cost).append(',');
proc.append(cost).append(',');
proc.append(encounter.claim.person.coverage.getTotalCoverage()).append(',');
proc.append(cost).append(',');
proc.append(0.00).append(',');
proc.append(cost).append(',');
proc.append(cost).append(',');
proc.append(0.00).append(',');
proc.append(0.00).append(',');
proc.append(0.00).append(',');
if (procedure.reasons.size() != 0) {
Code reasons = procedure.reasons.get(0);
proc.append(reasons.code).append(',');
proc.append(clean(reasons.display)).append(',');
proc.append(presentOnAdmission).append(',');
proc.append(diagnosisCode).append(',');
proc.append(diagnosisType).append(',');
} else {
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
}
proc.append("").append(',');
Code procedureCode = procedure.codes.get(0);
proc.append(procedureCode.code).append(',');
proc.append(clean(procedureCode.display)).append(',');
proc.append(dateFromTimestamp(procedure.start)).append(',');
proc.append(diagnosisCode).append(',');
proc.append(procedureType).append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(',');
proc.append("").append(NEWLINE);
s.append(proc.toString());
i++;
}
// pharmacy
for (Medication medication : encounter.medications) {
StringBuilder med = new StringBuilder();
String presentOnAdmission;
String diagnosisCode = "SNOMED";
String diagnosisType = "principal";
String[] poaCodes = { "Y", "N", "U", "W" };
presentOnAdmission = poaCodes[(int) randomLongWithBounds(0, 3)];
String[] brandGenericList = { "b", "g" };
String brandGenericCode = brandGenericList[(int) randomLongWithBounds(0, 1)];
String[] dawCodeList = { "1", "2", "3", "4", "7", "1", "3", "5", "8" };
String dawCode;
if (brandGenericCode.equals("b")) {
dawCode = dawCodeList[(int) randomLongWithBounds(0, 4)];
} else {
if (brandGenericCode.equals("g")) {
dawCode = dawCodeList[(int) randomLongWithBounds(5, 8)];
} else {
dawCode = "0";
}
}
/*
* {"dosage": {"amount":1,"frequency":2,"period":1,"unit":"days"},
* "duration":{"quantity":2,"unit":"weeks"}, "instructions":[ {
* "system":"SNOMED-CT", "code":"code", "display":"display string"} ] }
*/
JsonObject medicationDetails = medication.prescriptionDetails;
Dictionary<String, Integer> dayMultiplier = new Hashtable<String, Integer>();
dayMultiplier.put("hours", 1);
dayMultiplier.put("days", 1);
dayMultiplier.put("weeks", 2);
dayMultiplier.put("months", 30);
dayMultiplier.put("years", 365);
int dailyDosage;
int daysSupply;
JsonObject dosage;
JsonObject duration;
if (medicationDetails == null || medicationDetails.has("as_needed")) {
dailyDosage = 0;
daysSupply = 0;
} else {
if (medicationDetails != null && medicationDetails.has("dosage")) {
dosage = medicationDetails.get("dosage").getAsJsonObject();
if (dosage.has("amount") == false) {
dosage.addProperty("amount", 0);
}
if (dosage.has("frequency") == false) {
dosage.addProperty("frequency", 0);
}
if (dosage.has("period") == false) {
dosage.addProperty("period", 0);
}
if (dosage.has("unit") == false) {
dosage.addProperty("unit", "days");
}
} else {
dosage = new JsonObject();
dosage.addProperty("amount", 0);
dosage.addProperty("frequency", 0);
dosage.addProperty("period", 0);
dosage.addProperty("unit", "days");
}
if (medicationDetails != null && medicationDetails.has("duration")) {
duration = medicationDetails.get("duration").getAsJsonObject();
if (duration.has("quantity") == false) {
duration.addProperty("quantity", 0);
}
if (duration.has("unit") == false) {
duration.addProperty("unit", "days");
}
} else {
duration = new JsonObject();
duration.addProperty("quantity", 0);
duration.addProperty("unit", "days");
}
dailyDosage = dosage.get("amount").getAsInt() * dosage.get("frequency").getAsInt() * dosage.get("period").getAsInt() * (int) dayMultiplier.get(dosage.get("unit").getAsString());
daysSupply = duration.get("quantity").getAsInt() * dayMultiplier.get(duration.get("unit").getAsString());
}
UUID rxRef = rand.randUUID();
String[] serviceTypeList = { "01", "04", "06" };
String serviceType = serviceTypeList[(int) randomLongWithBounds(0, 2)];
med.append(adminString);
med.append(daysSupply).append(',');
med.append(rxRef).append(',');
med.append(dawCode).append(',');
med.append("0").append(',');
med.append("0").append(',');
med.append(brandGenericCode).append(',');
med.append(serviceType).append(',');
med.append(attributes.getResidence()).append(',');
med.append(providerString);
med.append(totalsString);
Code coding = medication.codes.get(0);
med.append(dateFromTimestamp(medication.start)).append(',');
med.append(i).append(',');
med.append(dateFromTimestamp(medication.stop)).append(',');
med.append("16").append(',');
med.append("01").append(',');
med.append(attributes.getRevenueCenterCode()).append(',');
med.append(dailyDosage * daysSupply).append(',');
med.append(dailyDosage * daysSupply).append(',');
med.append(coding.code).append(',');
med.append(randomLongWithBounds(0, 2)).append(',');
med.append(dailyDosage * daysSupply).append(',');
med.append("UN").append(',');
med.append(attributes.getBenefitPaymentStatus()).append(',');
med.append(attributes.getDenialCode()).append(',');
BigDecimal cost = medication.getCost();
med.append(0.00).append(',');
med.append(0.00).append(',');
med.append(0.00).append(',');
med.append((dailyDosage == 0 || daysSupply == 0 ? 0 : cost.longValue() / (dailyDosage * daysSupply))).append(',');
med.append(cost).append(',');
med.append(cost).append(',');
med.append(encounter.claim.person.coverage.getTotalCoverage()).append(',');
med.append(cost).append(',');
med.append(0.00).append(',');
med.append(cost).append(',');
med.append(cost).append(',');
med.append(0.00).append(',');
med.append(0.00).append(',');
med.append(0.00).append(',');
if (medication.reasons.size() != 0) {
Code reasons = medication.reasons.get(0);
med.append(reasons.code).append(',');
med.append(clean(reasons.display)).append(',');
med.append(presentOnAdmission).append(',');
med.append(diagnosisCode).append(',');
med.append(diagnosisType).append(',');
} else {
med.append("").append(',');
med.append("").append(',');
med.append("").append(',');
med.append("").append(',');
med.append("").append(',');
}
med.append("").append(',');
med.append(procedureEMPTY).append(NEWLINE);
s.append(med.toString());
i++;
}
// Devices
for (Device device : encounter.devices) {
StringBuilder dev = new StringBuilder();
dev.append(adminString);
dev.append(",").append(",").append(",").append(",").append(",").append(",");
dev.append("01,").append(attributes.getResidence()).append(',');
dev.append(providerString);
dev.append(totalsString);
String typeOfService = "01";
if (attributes.getNetworkStatus().equals("out")) {
typeOfService = "11";
}
dev.append(dateFromTimestamp(device.start)).append(',');
dev.append(i).append(',');
dev.append(dateFromTimestamp(device.stop)).append(',');
dev.append(typeOfService).append(',');
dev.append(attributes.getPlaceOfService()).append(',');
dev.append(attributes.getRevenueCenterCode()).append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append(attributes.getBenefitPaymentStatus()).append(',');
dev.append(attributes.getDenialCode()).append(',');
BigDecimal cost = device.getCost();
dev.append(0.00).append(',');
dev.append(0.00).append(',');
dev.append(0.00).append(',');
dev.append("").append(',');
dev.append(cost).append(',');
dev.append(cost).append(',');
dev.append(encounter.claim.person.coverage.getTotalCoverage()).append(',');
dev.append(cost).append(',');
dev.append(0.00).append(',');
dev.append(cost).append(',');
dev.append(cost).append(',');
dev.append(0.00).append(',');
dev.append(0.00).append(',');
dev.append(0.00).append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
String diagnosisCode = "SNOMED";
String deviceType = "";
Code deviceCode = device.codes.get(0);
dev.append(deviceCode.code).append(',');
dev.append(clean(deviceCode.display)).append(',');
dev.append(dateFromTimestamp(device.start)).append(',');
dev.append(diagnosisCode).append(',');
dev.append(deviceType).append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(',');
dev.append("").append(NEWLINE);
s.append(dev.toString());
i++;
}
}
write(s.toString(), claims);
}
Also used :
Hashtable(java.util.Hashtable)
Device(org.mitre.synthea.world.concepts.HealthRecord.Device)
JsonObject(com.google.gson.JsonObject)
Code(org.mitre.synthea.world.concepts.HealthRecord.Code)
BigDecimal(java.math.BigDecimal)
Entry(org.mitre.synthea.world.concepts.HealthRecord.Entry)
Medication(org.mitre.synthea.world.concepts.HealthRecord.Medication)
Procedure(org.mitre.synthea.world.concepts.HealthRecord.Procedure)
UUID(java.util.UUID)
Example 2 with Device
use of org.mitre.synthea.world.concepts.HealthRecord.Device in project synthea by synthetichealth.
the class CSVExporter method export.
/**
* Add a single Person's health record info to the CSV records.
*
* @param person Person to write record data for
* @param time Time the simulation ended
* @throws IOException if any IO error occurs
*/
public void export(Person person, long time) throws IOException {
String personID = patient(person, time);
for (Encounter encounter : person.record.encounters) {
String encounterID = encounter(person, personID, encounter);
String payerID = encounter.claim.payer.uuid;
claim(person, encounter.claim, encounter, encounterID, time);
for (HealthRecord.Entry condition : encounter.conditions) {
/* condition to ignore codes other then retrieved from terminology url */
if (!StringUtils.isEmpty(Config.get("generate.terminology_service_url")) && !RandomCodeGenerator.selectedCodes.isEmpty()) {
if (RandomCodeGenerator.selectedCodes.stream().filter(code -> code.code.equals(condition.codes.get(0).code)).findFirst().isPresent()) {
condition(personID, encounterID, condition);
}
} else {
condition(personID, encounterID, condition);
}
}
for (HealthRecord.Allergy allergy : encounter.allergies) {
allergy(personID, encounterID, allergy);
}
for (Observation observation : encounter.observations) {
observation(personID, encounterID, observation);
}
for (Procedure procedure : encounter.procedures) {
procedure(personID, encounterID, procedure);
}
for (Medication medication : encounter.medications) {
medication(personID, encounterID, payerID, medication, time);
claim(person, medication.claim, encounter, encounterID, time);
}
for (HealthRecord.Entry immunization : encounter.immunizations) {
immunization(personID, encounterID, immunization);
}
for (CarePlan careplan : encounter.careplans) {
careplan(person, personID, encounterID, careplan);
}
for (ImagingStudy imagingStudy : encounter.imagingStudies) {
imagingStudy(person, personID, encounterID, imagingStudy);
}
for (Device device : encounter.devices) {
device(personID, encounterID, device);
}
for (Supply supply : encounter.supplies) {
supply(personID, encounterID, encounter, supply);
}
}
CSVExporter.getInstance().exportPayerTransitions(person, time);
int yearsOfHistory = Integer.parseInt(Config.get("exporter.years_of_history"));
Calendar cutOff = new GregorianCalendar(1900, 0, 1);
if (yearsOfHistory > 0) {
cutOff = Calendar.getInstance();
cutOff.set(cutOff.get(Calendar.YEAR) - yearsOfHistory, 0, 1);
}
Calendar now = Calendar.getInstance();
Calendar birthDay = Calendar.getInstance();
birthDay.setTimeInMillis((long) person.attributes.get(Person.BIRTHDATE));
String[] gbdMetrics = { QualityOfLifeModule.QALY, QualityOfLifeModule.DALY, QualityOfLifeModule.QOLS };
String unit = null;
for (String score : gbdMetrics) {
if (score.equals(QualityOfLifeModule.QOLS)) {
unit = "{score}";
} else {
// years in UCUM is "a" for Latin "Annus"
unit = "a";
}
@SuppressWarnings("unchecked") Map<Integer, Double> scores = (Map<Integer, Double>) person.attributes.get(score);
for (Integer year : scores.keySet()) {
birthDay.set(Calendar.YEAR, year);
if (birthDay.after(cutOff) && birthDay.before(now)) {
Observation obs = person.record.new Observation(birthDay.getTimeInMillis(), score, scores.get(year));
obs.unit = unit;
Code code = new Code("GBD", score, score);
obs.codes.add(code);
observation(personID, "", obs);
}
}
}
patients.flush();
encounters.flush();
conditions.flush();
allergies.flush();
medications.flush();
careplans.flush();
observations.flush();
procedures.flush();
immunizations.flush();
imagingStudies.flush();
devices.flush();
supplies.flush();
claims.flush();
claimsTransactions.flush();
}
Also used :
Device(org.mitre.synthea.world.concepts.HealthRecord.Device)
GregorianCalendar(java.util.GregorianCalendar)
Calendar(java.util.Calendar)
Supply(org.mitre.synthea.world.concepts.HealthRecord.Supply)
GregorianCalendar(java.util.GregorianCalendar)
ImagingStudy(org.mitre.synthea.world.concepts.HealthRecord.ImagingStudy)
Code(org.mitre.synthea.world.concepts.HealthRecord.Code)
AtomicInteger(java.util.concurrent.atomic.AtomicInteger)
HealthRecord(org.mitre.synthea.world.concepts.HealthRecord)
CarePlan(org.mitre.synthea.world.concepts.HealthRecord.CarePlan)
Entry(org.mitre.synthea.world.concepts.HealthRecord.Entry)
Observation(org.mitre.synthea.world.concepts.HealthRecord.Observation)
Medication(org.mitre.synthea.world.concepts.HealthRecord.Medication)
Encounter(org.mitre.synthea.world.concepts.HealthRecord.Encounter)
Procedure(org.mitre.synthea.world.concepts.HealthRecord.Procedure)
Map(java.util.Map)
Example 3 with Device
use of org.mitre.synthea.world.concepts.HealthRecord.Device in project synthea by synthetichealth.
the class BB2RIFExporter method exportDME.
/**
* Export DME details for a single person.
* @param person the person to export
* @param startTime earliest claim date to export
* @param stopTime end time of simulation
* @throws IOException if something goes wrong
*/
private void exportDME(Person person, long startTime, long stopTime) throws IOException {
HashMap<DME, String> fieldValues = new HashMap<>();
for (HealthRecord.Encounter encounter : person.record.encounters) {
if (encounter.stop < startTime || encounter.stop < claimCutoff) {
continue;
}
boolean isVA = (ProviderType.VETERAN == encounter.provider.type);
// IHS facilities have valid 6 digit id, IHS centers don't
boolean isIHSCenter = (ProviderType.IHS == encounter.provider.type) && encounter.provider.id.length() != 6;
if (isVA || isIHSCenter) {
continue;
}
long claimId = BB2RIFExporter.claimId.getAndDecrement();
int claimGroupId = BB2RIFExporter.claimGroupId.getAndDecrement();
long carrClmId = BB2RIFExporter.carrClmCntlNum.getAndDecrement();
double latestHemoglobin = 0;
for (HealthRecord.Observation observation : encounter.observations) {
if (observation.containsCode("718-7", "http://loinc.org")) {
latestHemoglobin = (double) observation.value;
}
}
fieldValues.clear();
staticFieldConfig.setValues(fieldValues, DME.class, person);
// complex fields that could not easily be set using cms_field_values.tsv
fieldValues.put(DME.CLM_ID, "" + claimId);
fieldValues.put(DME.CLM_GRP_ID, "" + claimGroupId);
fieldValues.put(DME.CARR_CLM_CNTL_NUM, "" + carrClmId);
fieldValues.put(DME.BENE_ID, (String) person.attributes.get(BB2_BENE_ID));
fieldValues.put(DME.LINE_HCT_HGB_RSLT_NUM, "" + latestHemoglobin);
fieldValues.put(DME.CARR_NUM, getCarrier(encounter.provider.state, CARRIER.CARR_NUM));
fieldValues.put(DME.NCH_WKLY_PROC_DT, bb2DateFromTimestamp(ExportHelper.nextFriday(encounter.stop)));
fieldValues.put(DME.PRVDR_NUM, encounter.provider.id);
fieldValues.put(DME.PRVDR_NPI, encounter.provider.npi);
fieldValues.put(DME.RFR_PHYSN_NPI, encounter.clinician.npi);
fieldValues.put(DME.PRVDR_SPCLTY, ClinicianSpecialty.getCMSProviderSpecialtyCode((String) encounter.clinician.attributes.get(Clinician.SPECIALTY)));
fieldValues.put(DME.PRVDR_STATE_CD, locationMapper.getStateCode(encounter.provider.state));
fieldValues.put(DME.TAX_NUM, bb2TaxId((String) encounter.clinician.attributes.get(Person.IDENTIFIER_SSN)));
fieldValues.put(DME.DMERC_LINE_PRCNG_STATE_CD, locationMapper.getStateCode((String) person.attributes.get(Person.STATE)));
fieldValues.put(DME.LINE_1ST_EXPNS_DT, bb2DateFromTimestamp(encounter.start));
fieldValues.put(DME.LINE_LAST_EXPNS_DT, bb2DateFromTimestamp(encounter.stop));
fieldValues.put(DME.LINE_SRVC_CNT, "" + encounter.claim.items.size());
fieldValues.put(DME.LINE_PLACE_OF_SRVC_CD, getPlaceOfService(encounter));
// OPTIONAL
if (encounter.reason != null) {
// values into the principle diagnoses code.
if (conditionCodeMapper.canMap(encounter.reason.code)) {
String icdCode = conditionCodeMapper.map(encounter.reason.code, person, true);
fieldValues.put(DME.PRNCPAL_DGNS_CD, icdCode);
fieldValues.put(DME.LINE_ICD_DGNS_CD, icdCode);
}
}
// Use the active condition diagnoses to enter mapped values
// into the diagnoses codes.
List<String> mappedDiagnosisCodes = getDiagnosesCodes(person, encounter.stop);
if (mappedDiagnosisCodes.isEmpty()) {
// skip this encounter
continue;
}
int smallest = Math.min(mappedDiagnosisCodes.size(), BB2RIFStructure.dmeDxFields.length);
for (int i = 0; i < smallest; i++) {
DME[] dxField = BB2RIFStructure.dmeDxFields[i];
fieldValues.put(dxField[0], mappedDiagnosisCodes.get(i));
// 0=ICD10
fieldValues.put(dxField[1], "0");
}
if (!fieldValues.containsKey(DME.PRNCPAL_DGNS_CD)) {
fieldValues.put(DME.PRNCPAL_DGNS_CD, mappedDiagnosisCodes.get(0));
fieldValues.put(DME.LINE_ICD_DGNS_CD, mappedDiagnosisCodes.get(0));
}
// preprocess some subtotals...
ClaimEntry subTotals = (encounter.claim).new ClaimEntry(null);
for (ClaimEntry lineItem : encounter.claim.items) {
if (lineItem.entry instanceof Device || lineItem.entry instanceof Supply) {
subTotals.addCosts(lineItem);
}
}
fieldValues.put(DME.CARR_CLM_CASH_DDCTBL_APLD_AMT, String.format("%.2f", subTotals.deductible));
fieldValues.put(DME.CARR_CLM_PRMRY_PYR_PD_AMT, String.format("%.2f", subTotals.coinsurance.add(subTotals.payer)));
fieldValues.put(DME.NCH_CARR_CLM_ALOWD_AMT, String.format("%.2f", subTotals.cost.subtract(subTotals.adjustment)));
fieldValues.put(DME.NCH_CARR_CLM_SBMTD_CHRG_AMT, String.format("%.2f", subTotals.cost));
fieldValues.put(DME.NCH_CLM_PRVDR_PMT_AMT, String.format("%.2f", subTotals.coinsurance.add(subTotals.payer)));
fieldValues.put(DME.CLM_PMT_AMT, String.format("%.2f", subTotals.coinsurance.add(subTotals.payer)));
synchronized (rifWriters.getOrCreateWriter(DME.class)) {
int lineNum = 1;
// Now generate the line items...
for (ClaimEntry lineItem : encounter.claim.items) {
if (!(lineItem.entry instanceof Device || lineItem.entry instanceof Supply)) {
continue;
}
if (lineItem.entry instanceof Supply) {
Supply supply = (Supply) lineItem.entry;
fieldValues.put(DME.DMERC_LINE_MTUS_CNT, "" + supply.quantity);
} else {
fieldValues.put(DME.DMERC_LINE_MTUS_CNT, "");
}
if (!dmeCodeMapper.canMap(lineItem.entry.codes.get(0).code)) {
System.err.println(" *** Possibly Missing DME Code: " + lineItem.entry.codes.get(0).code + " " + lineItem.entry.codes.get(0).display);
continue;
}
fieldValues.put(DME.CLM_FROM_DT, bb2DateFromTimestamp(lineItem.entry.start));
fieldValues.put(DME.CLM_THRU_DT, bb2DateFromTimestamp(lineItem.entry.start));
String hcpcsCode = dmeCodeMapper.map(lineItem.entry.codes.get(0).code, person);
fieldValues.put(DME.HCPCS_CD, hcpcsCode);
if (betosCodeMapper.canMap(hcpcsCode)) {
fieldValues.put(DME.BETOS_CD, betosCodeMapper.map(hcpcsCode, person));
} else {
fieldValues.put(DME.BETOS_CD, "");
}
fieldValues.put(DME.LINE_CMS_TYPE_SRVC_CD, dmeCodeMapper.map(lineItem.entry.codes.get(0).code, DME.LINE_CMS_TYPE_SRVC_CD.toString().toLowerCase(), person));
fieldValues.put(DME.LINE_BENE_PTB_DDCTBL_AMT, String.format("%.2f", lineItem.deductible));
fieldValues.put(DME.LINE_COINSRNC_AMT, String.format("%.2f", lineItem.getCoinsurancePaid()));
fieldValues.put(DME.LINE_BENE_PMT_AMT, String.format("%.2f", lineItem.copay.add(lineItem.deductible).add(lineItem.pocket)));
fieldValues.put(DME.LINE_PRVDR_PMT_AMT, String.format("%.2f", lineItem.coinsurance.add(lineItem.payer)));
fieldValues.put(DME.LINE_SBMTD_CHRG_AMT, String.format("%.2f", lineItem.cost));
fieldValues.put(DME.LINE_ALOWD_CHRG_AMT, String.format("%.2f", lineItem.cost.subtract(lineItem.adjustment)));
fieldValues.put(DME.LINE_PRMRY_ALOWD_CHRG_AMT, String.format("%.2f", lineItem.cost.subtract(lineItem.adjustment)));
fieldValues.put(DME.LINE_NCH_PMT_AMT, String.format("%.2f", lineItem.coinsurance.add(lineItem.payer)));
// set the line number and write out field values
fieldValues.put(DME.LINE_NUM, Integer.toString(lineNum++));
rifWriters.writeValues(DME.class, fieldValues);
}
}
}
}
Also used :
HashMap(java.util.HashMap)
LinkedHashMap(java.util.LinkedHashMap)
Device(org.mitre.synthea.world.concepts.HealthRecord.Device)
Supply(org.mitre.synthea.world.concepts.HealthRecord.Supply)
ClaimEntry(org.mitre.synthea.world.concepts.Claim.ClaimEntry)
HealthRecord(org.mitre.synthea.world.concepts.HealthRecord)
DME(org.mitre.synthea.export.BB2RIFStructure.DME)
Aggregations
Device (org.mitre.synthea.world.concepts.HealthRecord.Device)3
HealthRecord (org.mitre.synthea.world.concepts.HealthRecord)2
Code (org.mitre.synthea.world.concepts.HealthRecord.Code)2
Entry (org.mitre.synthea.world.concepts.HealthRecord.Entry)2
Medication (org.mitre.synthea.world.concepts.HealthRecord.Medication)2
Procedure (org.mitre.synthea.world.concepts.HealthRecord.Procedure)2
Supply (org.mitre.synthea.world.concepts.HealthRecord.Supply)2
JsonObject (com.google.gson.JsonObject)1
BigDecimal (java.math.BigDecimal)1
Calendar (java.util.Calendar)1
GregorianCalendar (java.util.GregorianCalendar)1
HashMap (java.util.HashMap)1
Hashtable (java.util.Hashtable)1
LinkedHashMap (java.util.LinkedHashMap)1
Map (java.util.Map)1
UUID (java.util.UUID)1
AtomicInteger (java.util.concurrent.atomic.AtomicInteger)1
DME (org.mitre.synthea.export.BB2RIFStructure.DME)1
ClaimEntry (org.mitre.synthea.world.concepts.Claim.ClaimEntry)1
CarePlan (org.mitre.synthea.world.concepts.HealthRecord.CarePlan)1
