BFD-3372: Ingest RDA API v0.14.1 fields (#2283)

apps/bfd-model/bfd-model-rda/mappings/FissClaim.yaml

@@ -442,6 +442,10 @@ mappings:
       comment: 'Medical Record Number: This field identifies the number assigned to
         the patient''s medical/health record by the provider.'
       dbName: medical_record_no
+    - name: admTypCd
+      sqlType: varchar(2)
+      comment: 'Indicates the type and priority of inpatient services.'
+      dbName: adm_typ_cd
     - name: mbiId
       dbName: mbi_id
       sqlType: bigint
@@ -701,5 +705,9 @@ mappings:
   - from: fissRevenueLines
     to: revenueLines
     transformer: Array
+  - from: admTypCd
+    transformer: MessageEnum
+    transformerOptions:
+      enumClass: gov.cms.mpsm.rda.v1.fiss.FissAdmTypeCode
   externalTransformations:
   - applyMbiCache

apps/bfd-model/bfd-model-rda/mappings/FissRevenueLine.yaml

@@ -115,6 +115,19 @@ mappings:
         or the service is for home health Part B; this field will identify the applicable 
         adjustment group code that defines the liability for adjustments in charges
         occurring from this payment reduction.'
+    - name: ndc
+      sqlType: varchar(11)
+      dbName: ndc
+      comment: 'This field identifies the NDC assigned to each medication.'
+    - name: ndcQty
+      sqlType: varchar(11)
+      dbName: ndc_qty
+      comment: 'This field identifies the quantity of the NDC medication administered.'
+    - name: ndcQtyQual
+      sqlType: varchar(2)
+      dbName: ndc_qty_qual
+      comment: 'This field identifies the measurement qualifier for the quantity of the NDC medication administered.'
+
   transformations:
   - from: PARENT
     to: claimId
@@ -143,3 +156,9 @@ mappings:
   - from: acoRedRarc
   - from: acoRedCarc
   - from: acoRedCagc
+  - from: ndc
+  - from: ndcQty
+  - from: ndcQtyQual
+    transformer: MessageEnum
+    transformerOptions:
+      enumClass: gov.cms.mpsm.rda.v1.fiss.FissNdcQtyQual

apps/bfd-model/bfd-model-rda/mappings/McsDetail.yaml

@@ -274,6 +274,17 @@ mappings:
       dbName: idr_dtl_amb_dropoff_zipcode
       comment: 'Ambulance Drop-off Location ZIP Code: This field contains the ambulance
         drop-off location''s zip code.'
+    - name: idrDtlNdc
+      sqlType: varchar(48)
+      dbName: idr_dtl_ndc
+      comment: 'Detail level NDC (National Drug Code): This field holds the data from 
+        segment 2410-LIN03 of claims submitted in 5010A1 format.'
+    - name: idrDtlNdcUnitCount
+      sqlType: varchar(15)
+      dbName: idr_dtl_ndc_unit_count
+      comment: 'Detail level NDC (National Drug Code) Units: This field holds the data
+        from 5010A format 2410 CTP04 claims.'
+
   transformations:
   - from: PARENT
     to: idrClmHdIcn
@@ -333,3 +344,5 @@ mappings:
   - from: idrDtlAmbDropoffCity
   - from: idrDtlAmbDropoffState
   - from: idrDtlAmbDropoffZipcode
+  - from: idrDtlNdc
+  - from: idrDtlNdcUnitCount

apps/bfd-model/bfd-model-rif/src/main/resources/db/migration/V118__rda_0_14_1_updates.sql

@@ -0,0 +1,19 @@
+-- As part of the 0.14.1 RDA API update, new fields added
+
+/*
+* fiss_claims
+*/
+ALTER TABLE rda.fiss_claims ADD adm_typ_cd varchar(2);
+
+/*
+* fiss_revenue_lines
+*/
+ALTER TABLE rda.fiss_revenue_lines ADD ndc varchar(11);
+ALTER TABLE rda.fiss_revenue_lines ADD ndc_qty varchar(11);
+ALTER TABLE rda.fiss_revenue_lines ADD ndc_qty_qual varchar(2);
+
+/*
+* mcs_details
+*/
+ALTER TABLE rda.mcs_details ADD idr_dtl_ndc varchar(48);
+ALTER TABLE rda.mcs_details ADD idr_dtl_ndc_unit_count varchar(15);

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/java/gov/cms/bfd/pipeline/rda/grpc/server/RandomFissClaimGenerator.java

@@ -3,6 +3,7 @@
 import com.google.common.annotations.VisibleForTesting;
 import gov.cms.mpsm.rda.v1.fiss.FissAdjustmentMedicareBeneficiaryIdentifierIndicator;
 import gov.cms.mpsm.rda.v1.fiss.FissAdjustmentRequestorCode;
+import gov.cms.mpsm.rda.v1.fiss.FissAdmTypeCode;
 import gov.cms.mpsm.rda.v1.fiss.FissAssignmentOfBenefitsIndicator;
 import gov.cms.mpsm.rda.v1.fiss.FissAuditTrail;
 import gov.cms.mpsm.rda.v1.fiss.FissBeneZPayer;
@@ -21,6 +22,7 @@
 import gov.cms.mpsm.rda.v1.fiss.FissDiagnosisPresentOnAdmissionIndicator;
 import gov.cms.mpsm.rda.v1.fiss.FissHealthInsuranceClaimNumberOrMedicareBeneficiaryIdentifier;
 import gov.cms.mpsm.rda.v1.fiss.FissInsuredPayer;
+import gov.cms.mpsm.rda.v1.fiss.FissNdcQtyQual;
 import gov.cms.mpsm.rda.v1.fiss.FissNonBillRevCode;
 import gov.cms.mpsm.rda.v1.fiss.FissPatientRelationshipCode;
 import gov.cms.mpsm.rda.v1.fiss.FissPayer;
@@ -161,6 +163,14 @@ public class RandomFissClaimGenerator extends AbstractRandomClaimGenerator<FissC
   private static final List<FissNonBillRevCode> FissNonBillRevCodeEnums =
       enumValues(FissNonBillRevCode.values());
 
+  /** A list of the enums for the fiss claim admission type codes. */
+  private static final List<FissAdmTypeCode> FissAdmTypeCodeEnums =
+      enumValues(FissAdmTypeCode.values());
+
+  /** A list of the enums for the fiss NDC measurement qualifiers. */
+  private static final List<FissNdcQtyQual> FissNdcQtyQualEnums =
+      enumValues(FissNdcQtyQual.values());
+
   /** Max length of a FISS claim id. */
   private static final int FissClaimIdLength = 32;
 
@@ -372,6 +382,10 @@ private void addRandomFieldValues(FissClaim.Builder claim) {
         () -> claim.setAdjMbiIndUnrecognized(randomAlphaNumeric(1, 1)));
     optional("adjMbi", () -> claim.setAdjMbi(randomAlphaNumeric(1, 11)));
     optional("medicalRecordNo", () -> claim.setMedicalRecordNo(randomAlphaNumeric(1, 17)));
+    optionalOneOf(
+        "admTypCd",
+        () -> claim.setAdmTypCdEnum(randomEnum(FissAdmTypeCodeEnums)),
+        () -> claim.setAdmTypCdUnrecognized(randomAlphaNumeric(1, 1)));
   }
 
   /**
@@ -619,6 +633,7 @@ private void addRandomAudits(FissClaim.Builder claim) {
   private void addRandomRevenueLines(FissClaim.Builder claim) {
     final int MAX_UNITS_BILLED = 50;
     final int MAX_SERV_UNIT_COUNT = 50;
+    final int MAX_NDC_QTY = 11;
 
     always(
         "revenue",
@@ -663,6 +678,11 @@ private void addRandomRevenueLines(FissClaim.Builder claim) {
                   optional("acoRedRarc", () -> revenue.setAcoRedRarc(randomAlphaNumeric(1, 5)));
                   optional("acoRedCarc", () -> revenue.setAcoRedCarc(randomAlphaNumeric(1, 3)));
                   optional("acoRedCagc", () -> revenue.setAcoRedCagc(randomAlphaNumeric(1, 2)));
+                  optional("ndc", () -> revenue.setNdc(randomAlphaNumeric(1, 11)));
+                  optional("ndcQty", () -> revenue.setNdcQty(randomDigit(1, MAX_NDC_QTY)));
+                  optional(
+                      "ndcQtyQual",
+                      () -> revenue.setNdcQtyQualEnum(randomEnum(FissNdcQtyQualEnums)));
                 });
 
             revenue.setRdaPosition(i);

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/java/gov/cms/bfd/pipeline/rda/grpc/server/RandomMcsClaimGenerator.java

@@ -467,6 +467,10 @@ private void addDetails(McsClaim.Builder claim, int detailCount) {
                   optional(
                       "idrDtlAmbDropoffZipcode",
                       (() -> detail.setIdrDtlAmbDropoffZipcode(randomAlphaNumeric(1, 9))));
+                  optional("idrDtlNdc", (() -> detail.setIdrDtlNdc(randomAlphaNumeric(1, 48))));
+                  optional(
+                      "idrDtlNdcUnitCount",
+                      (() -> detail.setIdrDtlNdcUnitCount(randomAlphaNumeric(1, 15))));
                 });
 
             claim.addMcsDetails(detail.build());

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/java/gov/cms/bfd/pipeline/rda/grpc/server/RdaService.java

@@ -25,7 +25,7 @@ public class RdaService extends RDAServiceGrpc.RDAServiceImplBase {
   private static final Logger LOGGER = LoggerFactory.getLogger(RdaService.class);
 
   /** The RDA server version to use when serving messages. */
-  public static final String RDA_PROTO_VERSION = "0.13.0";
+  public static final String RDA_PROTO_VERSION = "0.14.1";
 
   /** The source of claims for the server. */
   private final RdaMessageSourceFactory messageSourceFactory;

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/proto/rda/VERSION.txt

@@ -1 +1 @@
-0.13.0
+0.14.1

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/proto/rda/v1/fiss/fiss_adm_type_code.proto

@@ -0,0 +1,18 @@
+syntax = "proto3";
+
+package gov.cms.mpsm.rda.v1.fiss;
+
+option java_multiple_files = true;
+
+import "rda/v1/enum_options.proto";
+
+// FISS Adm Type Code
+enum FissAdmTypeCode {
+  ADM_TYPE_0 = 0 	        	  [(string_value) = "0"];
+  ADM_TYPE_EMERGENCY = 1      [(string_value) = "1"];
+  ADM_TYPE_URGENT = 2   		  [(string_value) = "2"];
+  ADM_TYPE_ELECTIVE = 3  		  [(string_value) = "3"];
+  ADM_TYPE_NEWBORN = 4        [(string_value) = "4"];
+  ADM_TYPE_TRAUMA_CENTER = 5  [(string_value) = "5"];
+  ADM_TYPE_9 = 6 		          [(string_value) = "9"];
+}

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/proto/rda/v1/fiss/fiss_claim.proto

@@ -25,6 +25,7 @@ import "rda/v1/fiss/fiss_repository_indicator.proto";
 import "rda/v1/fiss/fiss_source_of_admission.proto";
 import "rda/v1/fiss/fiss_revenue_line.proto";
 import "rda/v1/fiss/fiss_claim_type_indicator.proto";
+import "rda/v1/fiss/fiss_adm_type_code.proto";
 
 // FISS (Fiscal Intermediary Shared Systems) Claim
 message FissClaim {
@@ -356,6 +357,12 @@ message FissClaim {
     string clm_typ_ind_unrecognized = 109;
   };
 
+ // Adm Type Code
+ oneof adm_typ_cd {
+   FissAdmTypeCode adm_typ_cd_enum = 114;
+   string adm_typ_cd_unrecognized = 115;
+ };
+
   // Adjustment Medicare Beneficiary Identifier
   optional string adj_mbi = 100;
 

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/proto/rda/v1/fiss/fiss_ndc_qty_qual.proto

@@ -0,0 +1,18 @@
+syntax = "proto3";
+
+package gov.cms.mpsm.rda.v1.fiss;
+
+option java_multiple_files = true;
+
+import "rda/v1/enum_options.proto";
+
+// FISS NDC quantity qualifier:
+//
+// This field identifies the NDC quantity qualifier
+enum FissNdcQtyQual {
+  NDC_QTY_QUAL_F2 = 0     [(string_value) = "F2"];
+  NDC_QTY_QUAL_GR = 1     [(string_value) = "GR"];
+  NDC_QTY_QUAL_ME = 2     [(string_value) = "ME"];
+  NDC_QTY_QUAL_ML = 3     [(string_value) = "ML"];
+  NDC_QTY_QUAL_UN = 4     [(string_value) = "UN"];
+}

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/proto/rda/v1/fiss/fiss_revenue_line.proto

@@ -6,6 +6,8 @@ option java_multiple_files = true;
 
 import "rda/v1/fiss/fiss_non_bill_rev_code.proto";
 import "rda/v1/fiss/fiss_claim_type_indicator.proto";
+import "rda/v1/fiss/fiss_adm_type_code.proto";
+import "rda/v1/fiss/fiss_ndc_qty_qual.proto";
 
 // FISS Revenue Line
 message FissRevenueLine {
@@ -21,6 +23,12 @@ message FissRevenueLine {
     string non_bill_rev_code_unrecognized = 17;
   }
 
+ // NDC Quantity Qual
+ oneof ndc_qty_qual {
+   FissNdcQtyQual ndc_qty_qual_enum = 34;
+   string ndc_qty_qual_unrecognized = 35;
+ }
+
   // Revenue Code
   optional string rev_cd = 18;
 
@@ -66,4 +74,10 @@ message FissRevenueLine {
 
   // Pioneer Accountable Care Organization (ACO) Reduction Group Code
   optional string aco_red_cagc = 33;
+
+ // NDC assigned to each medication
+ optional string ndc = 36;
+
+ // Quantity of NDC medication assigned
+ optional string ndc_qty = 37;
 }

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/main/proto/rda/v1/mcs/mcs_detail.proto

@@ -59,5 +59,7 @@ message McsDetail {
   optional string idr_dtl_amb_dropoff_city = 59;
   optional string idr_dtl_amb_dropoff_state = 60;
   optional string idr_dtl_amb_dropoff_zipcode = 61;
+  optional string idr_dtl_ndc = 62;
+  optional string idr_dtl_ndc_unit_count = 63;
   uint32 idr_dtl_number = 67;
 }

apps/bfd-pipeline/bfd-pipeline-rda-grpc/src/test/java/gov/cms/bfd/pipeline/rda/grpc/server/RandomFissClaimGeneratorTest.java

@@ -354,7 +354,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "f",
     "acoRedRarc": "1x4",
     "acoRedCarc": "g",
-    "acoRedCagc": "nz"
+    "acoRedCagc": "nz",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_GR",
+    "ndc": "jcmf6sx",
+    "ndcQty": "7936840010"
   }, {
     "rdaPosition": 2,
     "nonBillRevCodeUnrecognized": "m",
@@ -372,7 +375,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "df",
     "acoRedRarc": "p",
     "acoRedCarc": "t0",
-    "acoRedCagc": "tm"
+    "acoRedCagc": "tm",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_F2",
+    "ndc": "dnmvqsj",
+    "ndcQty": "1309901"
   }, {
     "rdaPosition": 3,
     "nonBillRevCodeEnum": "NON_BILL_INVALID_REV_CODE",
@@ -390,7 +396,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "8",
     "acoRedRarc": "c1c7",
     "acoRedCarc": "67",
-    "acoRedCagc": "tv"
+    "acoRedCagc": "tv",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_F2",
+    "ndc": "nt4chn640z0",
+    "ndcQty": "6727587507"
   }, {
     "rdaPosition": 4,
     "nonBillRevCodeEnum": "NON_BILL_INVALID_HCPCS_HC",
@@ -408,7 +417,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "rg",
     "acoRedRarc": "ntq",
     "acoRedCarc": "z7",
-    "acoRedCagc": "3x"
+    "acoRedCagc": "3x",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_UN",
+    "ndc": "p4g",
+    "ndcQty": "4149"
   }, {
     "rdaPosition": 5,
     "nonBillRevCodeEnum": "NON_BILL_S",
@@ -426,7 +438,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "f",
     "acoRedRarc": "x",
     "acoRedCarc": "s95",
-    "acoRedCagc": "k2"
+    "acoRedCagc": "k2",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_F2",
+    "ndc": "612jg4h6gx",
+    "ndcQty": "253"
   }, {
     "rdaPosition": 6,
     "nonBillRevCodeEnum": "NON_BILL_ESRD",
@@ -444,7 +459,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "x",
     "acoRedRarc": "svf7",
     "acoRedCarc": "5",
-    "acoRedCagc": "xv"
+    "acoRedCagc": "xv",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_ME",
+    "ndc": "ps",
+    "ndcQty": "14975409"
   }, {
     "rdaPosition": 7,
     "nonBillRevCodeEnum": "NON_BILL_T",
@@ -462,7 +480,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "8m",
     "acoRedRarc": "sh1zj",
     "acoRedCarc": "054",
-    "acoRedCagc": "93"
+    "acoRedCagc": "93",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_ML",
+    "ndc": "9nrj",
+    "ndcQty": "98448896"
   }, {
     "rdaPosition": 8,
     "nonBillRevCodeEnum": "NON_BILL_INVALID_HCPCS_EMC",
@@ -480,7 +501,10 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "6",
     "acoRedRarc": "df57b",
     "acoRedCarc": "rt",
-    "acoRedCagc": "q"
+    "acoRedCagc": "q",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_ME",
+    "ndc": "36g",
+    "ndcQty": "36115325290"
   }, {
     "rdaPosition": 9,
     "nonBillRevCodeEnum": "NON_BILL_INVALID_REV_CODE",
@@ -498,15 +522,19 @@ public void randomClaim() throws InvalidProtocolBufferException {
     "hcpcModifier5": "9",
     "acoRedRarc": "rjfgw",
     "acoRedCarc": "2xb",
-    "acoRedCagc": "1"
+    "acoRedCagc": "1",
+    "ndcQtyQualEnum": "NDC_QTY_QUAL_UN",
+    "ndc": "dksxpmx1dt",
+    "ndcQty": "09102"
   }],
   "drgCd": "0",
   "groupCode": "1",
   "clmTypIndEnum": "CLAIM_TYPE_TOB_X20_X28",
   "recdDtCymdText": "2021-01-15",
   "currTranDtCymdText": "2021-05-07",
   "rdaClaimKey": "79173353508803659401417553844541",
-  "intermediaryNb": "82320"
+  "intermediaryNb": "82320",
+  "admTypCdEnum": "ADM_TYPE_9"
 }""",
         json);
   }