BFD-3449: Replace system for clm_ip_admsn_type_cd (#2359)

CMSgov · Jul 9, 2024 · 0d0dea9 · 0d0dea9
1 parent cd82e3c
commit 0d0dea9
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Showing 21 changed files with 132 additions and 59 deletions.
diff --git a/apps/bfd-server/bfd-server-docs/data-dictionary/data/V1/0055_clm_ip_admsn_type_cd.json b/apps/bfd-server/bfd-server-docs/data-dictionary/data/V1/0055_clm_ip_admsn_type_cd.json
@@ -31,7 +31,7 @@
             "element": "information[N].code.coding[N].code",
             "fhirPath": "",
             "discriminator": [
-                "information[N].code.coding[N].system = 'https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd'"
+                "information[N].code.coding[N].system = 'https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit'"
             ],
             "additional": [
                 "eob.information[N].code.coding[N].display = {corresponding description from valueset specified in .system}",

diff --git a/apps/bfd-server/bfd-server-docs/data-dictionary/data/V2/0055_clm_ip_admsn_type_cd.json b/apps/bfd-server/bfd-server-docs/data-dictionary/data/V2/0055_clm_ip_admsn_type_cd.json
@@ -29,22 +29,22 @@
             "version": "R4",
             "resource": "ExplanationOfBenefit",
             "element": "supportingInfo[N].code.coding[N].code",
-            "fhirPath": "supportingInfo.where(code.coding.where(system='https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd')).code.coding.code",
+            "fhirPath": "supportingInfo.where(code.coding.where(system='https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit')).code.coding.code",
             "discriminator": [
-                "supportingInfo[N].code.coding[N].system = 'https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd'"
+                "supportingInfo[N].code.coding[N].system = 'https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit'"
             ],
             "additional": [
                 "eob.supportingInfo[N].code.coding[N].display = {corresponding description from valueset specified in .system}",
-                "eob.supportingInfo[N].category.coding[N].system = 'http://terminology.hl7.org/CodeSystem/claiminformationcategory'",
-                "eob.supportingInfo[N].category.coding[N].code = 'info'",
+                "eob.supportingInfo[N].category.coding[N].system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType'",
+                "eob.supportingInfo[N].category.coding[N].code = 'admtype'",
                 "eob.supportingInfo[N].category.coding[N].display = 'Information')",
                 "eob.supportingInfo[N].category.coding[N].system = https://bluebutton.cms.gov/resources/codesystem/information'",
                 "eob.supportingInfo[N].category.coding[N].code = 'https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd'",
                 "eob.supportingInfo[N].category.coding[N].display = 'Claim Inpatient Admission Type Code')"
             ],
             "derived": "",
             "note": "",
-            "example": "[\\n  {\\n    \"sequence\": 3,\\n    \"category\": {\\n      \"coding\": [\\n        {\\n          \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\\n          \"code\": \"info\",\\n          \"display\": \"Information\"\\n        },\\n        {\\n          \"system\": \"https://bluebutton.cms.gov/resources/codesystem/information\",\\n          \"code\": \"https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd\",\\n          \"display\": \"Claim Inpatient Admission Type Code\"\\n        }\\n      ]\\n    },\\n    \"code\": {\\n      \"coding\": [\\n        {\\n          \"system\": \"https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd\",\\n          \"code\": \"1\",\\n          \"display\": \"Emergency - The patient required immediate medical intervention as a result of severe, life threatening, or potentially disabling conditions. Generally, the patient was admitted through the emergency room.\"\\n        }\\n      ]\\n    }\\n  }\\n]"
+            "example": "[\\n  {\\n    \"sequence\": 3,\\n    \"category\": {\\n      \"coding\": [\\n        {\\n          \"system\": \"http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType\",\\n          \"code\": \"admtype\",\\n          \"display\": \"Information\"\\n        },\\n        {\\n          \"system\": \"https://bluebutton.cms.gov/resources/codesystem/information\",\\n          \"code\": \"https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd\",\\n          \"display\": \"Claim Inpatient Admission Type Code\"\\n        }\\n      ]\\n    },\\n    \"code\": {\\n      \"coding\": [\\n        {\\n          \"system\": \"https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit\",\\n          \"code\": \"1\",\\n          \"display\": \"Emergency - The patient required immediate medical intervention as a result of severe, life threatening, or potentially disabling conditions. Generally, the patient was admitted through the emergency room.\"\\n        }\\n      ]\\n    }\\n  }\\n]"
         }
     ]
 }
diff --git a/apps/bfd-server/bfd-server-war/src/main/java/gov/cms/bfd/server/war/commons/CCWUtils.java b/apps/bfd-server/bfd-server-war/src/main/java/gov/cms/bfd/server/war/commons/CCWUtils.java
@@ -12,9 +12,26 @@ public class CCWUtils {
    *     published
    */
   public static String calculateVariableReferenceUrl(CcwCodebookInterface ccwVariable) {
-    return String.format(
-        "%s/%s",
-        TransformerConstants.BASE_URL_CCW_VARIABLES,
-        ccwVariable.getVariable().getId().toLowerCase());
+    return calculateVariableReferenceUrl(ccwVariable, false);
+  }
+
+  /**
+   * Calculates the variable reference url.
+   *
+   * @param ccwVariable the {@link CcwCodebookInterface} being mapped
+   * @param skipReplaceCcwSystem if set, {@link TransformerConstants#CCW_SYSTEM_MAP} will not be
+   *     checked.
+   * @return the public URL at which documentation for the specified {@link CcwCodebookInterface} is
+   *     published
+   */
+  public static String calculateVariableReferenceUrl(
+      CcwCodebookInterface ccwVariable, boolean skipReplaceCcwSystem) {
+    String ccwVarId = ccwVariable.getVariable().getId().toLowerCase();
+    // If the ccw variable exists in the CCW_SYSTEM_MAP map, then we can return the value of this
+    // mapping as the system. Otherwise, it will be constructed.
+    if (!skipReplaceCcwSystem && TransformerConstants.CCW_SYSTEM_MAP.containsKey(ccwVarId)) {
+      return TransformerConstants.CCW_SYSTEM_MAP.get(ccwVarId);
+    }
+    return String.format("%s/%s", TransformerConstants.BASE_URL_CCW_VARIABLES, ccwVarId);
   }
 }
diff --git a/...ver/bfd-server-war/src/main/java/gov/cms/bfd/server/war/commons/TransformerConstants.java b/...ver/bfd-server-war/src/main/java/gov/cms/bfd/server/war/commons/TransformerConstants.java
@@ -6,6 +6,8 @@
 import gov.cms.bfd.model.rif.entities.CarrierClaimColumn;
 import gov.cms.bfd.server.war.stu3.providers.PatientResourceProvider;
 import java.time.Instant;
+import java.util.HashMap;
+import java.util.Map;
 import org.hl7.fhir.dstu3.model.Coding;
 import org.hl7.fhir.dstu3.model.Coverage;
 import org.hl7.fhir.dstu3.model.Coverage.GroupComponent;
@@ -93,6 +95,50 @@ public final class TransformerConstants {
    */
   public static final String BASE_URL_CCW_VARIABLES = BASE_URL_BBAPI_RESOURCES + "/variables";
 
+  /** Base URL for nubc. */
+  public static final String BASE_URL_NUBC = "https://www.nubc.org";
+
+  /** System for NUBC admsn. */
+  public static final String NUBC_ADMIT_CODE_SYSTEM =
+      BASE_URL_NUBC + "/CodeSystem/PriorityTypeOfAdmitOrVisit";
+
+  /**
+   * Maps a ccw variable to a specific URL. If the variable exists as a key in this map, then the
+   * value will be used as the system; otherwise, it will be constructed using the above constants.
+   */
+  public static final Map<String, String> CCW_SYSTEM_MAP =
+      new HashMap<>() {
+        {
+          put("clm_ip_admsn_type_cd", NUBC_ADMIT_CODE_SYSTEM);
+        }
+      };
+
+  /** Constant for Carin BB base url. */
+  public static final String BASE_URL_CARIN_BB = "http://hl7.org/fhir/us/carin-bb";
+
+  /** Constant for Carin BB Information Category. */
+  public static final String CODING_CARIN_BB_INFORMATION_CATEGORY =
+      BASE_URL_CARIN_BB + "/CodeSystem/C4BBSupportingInfoType";
+
+  /** Constant for Carin BB admntype code. */
+  public static final String CARIN_BB_ADMN_TYPE = "admtype";
+
+  /** Maps a CCW variable for a category to a new system. */
+  public static final Map<String, String> CARIN_CATEGORY_SYSTEM_MAP =
+      new HashMap<>() {
+        {
+          put("clm_ip_admsn_type_cd", CODING_CARIN_BB_INFORMATION_CATEGORY);
+        }
+      };
+
+  /** Maps a CCW variable for a category to a new code. */
+  public static final Map<String, String> CARIN_CATEGORY_CODE_MAP =
+      new HashMap<>() {
+        {
+          put("clm_ip_admsn_type_cd", CARIN_BB_ADMN_TYPE);
+        }
+      };
+
   /** The constant for the USD code. */
   public static final String CODED_MONEY_USD = "USD";
 

diff --git a/.../bfd-server-war/src/main/java/gov/cms/bfd/server/war/r4/providers/TransformerUtilsV2.java b/.../bfd-server-war/src/main/java/gov/cms/bfd/server/war/r4/providers/TransformerUtilsV2.java
@@ -837,12 +837,17 @@ static CodeableConcept createCodeableConcept(
    */
   private static CodeableConcept createCodeableConceptForFieldId(
       IAnyResource rootResource, String codingSystem, CcwCodebookInterface ccwVariable) {
-    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
+    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable, true);
 
     Coding carinCoding =
         new Coding()
-            .setCode("info")
-            .setSystem(TransformerConstants.CARIN_SUPPORTING_INFO_TYPE)
+            .setCode(
+                TransformerConstants.CARIN_CATEGORY_CODE_MAP.getOrDefault(
+                    ccwVariable.getVariable().getId().toLowerCase(), "info"))
+            .setSystem(
+                TransformerConstants.CARIN_CATEGORY_SYSTEM_MAP.getOrDefault(
+                    ccwVariable.getVariable().getId().toLowerCase(),
+                    TransformerConstants.CARIN_SUPPORTING_INFO_TYPE))
             .setDisplay("Information");
     Coding cmsBBcoding = new Coding(codingSystem, code, ccwVariable.getVariable().getLabel());
 

diff --git a/...r/src/main/java/gov/cms/bfd/server/war/r4/providers/pac/common/AbstractTransformerV2.java b/...r/src/main/java/gov/cms/bfd/server/war/r4/providers/pac/common/AbstractTransformerV2.java
@@ -356,12 +356,17 @@ protected static CodeableConcept createCodeableConcept(C4BBIdentifierType idType
    */
   protected static CodeableConcept createCodeableConceptForCategory(
       String codingSystem, CcwCodebookInterface ccwVariable) {
-    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
+    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable, true);
 
     Coding carinCoding =
         new Coding()
-            .setCode("info")
-            .setSystem(TransformerConstants.CARIN_SUPPORTING_INFO_TYPE)
+            .setCode(
+                TransformerConstants.CARIN_CATEGORY_CODE_MAP.getOrDefault(
+                    ccwVariable.getVariable().getId().toLowerCase(), "info"))
+            .setSystem(
+                TransformerConstants.CARIN_CATEGORY_SYSTEM_MAP.getOrDefault(
+                    ccwVariable.getVariable().getId().toLowerCase(),
+                    TransformerConstants.CARIN_SUPPORTING_INFO_TYPE))
             .setDisplay("Information");
     Coding cmsBBcoding = new Coding(codingSystem, code, ccwVariable.getVariable().getLabel());
 

diff --git a/.../bfd-server-war/src/main/java/gov/cms/bfd/server/war/stu3/providers/TransformerUtils.java b/.../bfd-server-war/src/main/java/gov/cms/bfd/server/war/stu3/providers/TransformerUtils.java
@@ -1054,7 +1054,7 @@ static CodeableConcept createCodeableConcept(
    */
   private static CodeableConcept createCodeableConceptForFieldId(
       IAnyResource rootResource, String codingSystem, CcwCodebookInterface ccwVariable) {
-    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
+    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable, true);
     Coding coding = new Coding(codingSystem, code, ccwVariable.getVariable().getLabel());
 
     return new CodeableConcept().addCoding(coding);

diff --git a/...ar/src/test/java/gov/cms/bfd/server/war/r4/providers/InpatientClaimTransformerV2Test.java b/...ar/src/test/java/gov/cms/bfd/server/war/r4/providers/InpatientClaimTransformerV2Test.java
@@ -384,16 +384,16 @@ public void shouldHaveClmIpAdmsnTypeCdSupInfo() {
             // Category
             Arrays.asList(
                 new Coding(
-                    "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
-                    "info",
+                    "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                    "admtype",
                     "Information"),
                 new Coding(
                     "https://bluebutton.cms.gov/resources/codesystem/information",
                     "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
                     "Claim Inpatient Admission Type Code")),
             // Code
             new Coding(
-                "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+                "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
                 "1",
                 "Emergency - The patient required immediate medical intervention as a result of"
                     + " severe, life threatening, or potentially disabling conditions. Generally,"

diff --git a/...rver-war/src/test/java/gov/cms/bfd/server/war/r4/providers/SNFClaimTransformerV2Test.java b/...rver-war/src/test/java/gov/cms/bfd/server/war/r4/providers/SNFClaimTransformerV2Test.java
@@ -358,16 +358,16 @@ public void shouldHaveClmIpAdmsnTypeCdSupInfo() {
             // Category
             Arrays.asList(
                 new Coding(
-                    "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
-                    "info",
+                    "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
+                    "admtype",
                     "Information"),
                 new Coding(
                     "https://bluebutton.cms.gov/resources/codesystem/information",
                     "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
                     "Claim Inpatient Admission Type Code")),
             // Code
             new Coding(
-                "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+                "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
                 "3",
                 "Elective - The patient's condition permitted adequate time to schedule the availability of suitable accommodations."));
 

diff --git a/...bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobByPatientIdAll.json b/...bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobByPatientIdAll.json
@@ -1884,7 +1884,7 @@
         },
         "code" : {
           "coding" : [ {
-            "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+            "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
             "code" : "1",
             "display" : "Emergency - The patient required immediate medical intervention as a result of severe, life threatening, or potentially disabling conditions. Generally, the patient was admitted through the emergency room."
           } ]
@@ -2645,7 +2645,7 @@
         },
         "code" : {
           "coding" : [ {
-            "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+            "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
             "code" : "3",
             "display" : "Elective - The patient's condition permitted adequate time to schedule the availability of suitable accommodations."
           } ]

diff --git a/...d-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobByPatientIdPaged.json b/...d-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobByPatientIdPaged.json
@@ -1890,7 +1890,7 @@
         },
         "code" : {
           "coding" : [ {
-            "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+            "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
             "code" : "1",
             "display" : "Emergency - The patient required immediate medical intervention as a result of severe, life threatening, or potentially disabling conditions. Generally, the patient was admitted through the emergency room."
           } ]
@@ -2651,7 +2651,7 @@
         },
         "code" : {
           "coding" : [ {
-            "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+            "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
             "code" : "3",
             "display" : "Elective - The patient's condition permitted adequate time to schedule the availability of suitable accommodations."
           } ]

diff --git a/.../bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobReadInpatient.json b/.../bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobReadInpatient.json
@@ -279,7 +279,7 @@
     },
     "code" : {
       "coding" : [ {
-        "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+        "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
         "code" : "1",
         "display" : "Emergency - The patient required immediate medical intervention as a result of severe, life threatening, or potentially disabling conditions. Generally, the patient was admitted through the emergency room."
       } ]

diff --git a/apps/bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobReadSnf.json b/apps/bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v1/eobReadSnf.json
@@ -207,7 +207,7 @@
     },
     "code" : {
       "coding" : [ {
-        "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
+        "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit",
         "code" : "3",
         "display" : "Elective - The patient's condition permitted adequate time to schedule the availability of suitable accommodations."
       } ]

diff --git a/apps/bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v2/claimFissRead.json b/apps/bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v2/claimFissRead.json
@@ -184,9 +184,9 @@
     {
       "category" : {
         "coding" : [ {
-          "code" : "info",
+          "code" : "admtype",
           "display" : "Information",
-          "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory"
+          "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType"
         }, {
           "code" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
           "display" : "Claim Inpatient Admission Type Code",
@@ -196,7 +196,7 @@
       "code" : {
         "coding" : [ {
           "code" : "3",
-          "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd"
+          "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit"
         } ]
       },
       "sequence" : 3

diff --git a/.../bfd-server-war/src/test/resources/endpoint-responses/v2/claimFissReadWithTaxNumbers.json b/.../bfd-server-war/src/test/resources/endpoint-responses/v2/claimFissReadWithTaxNumbers.json
@@ -196,9 +196,9 @@
     }, {
       "category" : {
         "coding" : [ {
-          "code" : "info",
+          "code" : "admtype",
           "display" : "Information",
-          "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory"
+          "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType"
         }, {
           "code" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
           "display" : "Claim Inpatient Admission Type Code",
@@ -208,7 +208,7 @@
       "code" : {
         "coding" : [ {
           "code" : "3",
-          "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd"
+          "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit"
         } ]
       },
       "sequence" : 3

diff --git a/apps/bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v2/claimSearch.json b/apps/bfd-server/bfd-server-war/src/test/resources/endpoint-responses/v2/claimSearch.json
@@ -200,9 +200,9 @@
           {
             "category" : {
               "coding" : [ {
-                "code" : "info",
+                "code" : "admtype",
                 "display" : "Information",
-                "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory"
+                "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType"
               }, {
                 "code" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
                 "display" : "Claim Inpatient Admission Type Code",
@@ -212,7 +212,7 @@
             "code" : {
               "coding" : [ {
                 "code" : "3",
-                "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd"
+                "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit"
               } ]
             },
             "sequence" : 3

diff --git a/...er/bfd-server-war/src/test/resources/endpoint-responses/v2/claimSearchWithTaxNumbers.json b/...er/bfd-server-war/src/test/resources/endpoint-responses/v2/claimSearchWithTaxNumbers.json
@@ -213,9 +213,9 @@
           {
             "category" : {
               "coding" : [ {
-                "code" : "info",
+                "code" : "admtype",
                 "display" : "Information",
-                "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory"
+                "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType"
               }, {
                 "code" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd",
                 "display" : "Claim Inpatient Admission Type Code",
@@ -225,7 +225,7 @@
             "code" : {
               "coding" : [ {
                 "code" : "3",
-                "system" : "https://bluebutton.cms.gov/resources/variables/clm_ip_admsn_type_cd"
+                "system" : "https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit"
               } ]
             },
             "sequence" : 3