@cyanheads/medical-codes-mcp-server 0.1.0

package/LICENSE

@@ -0,0 +1,201 @@
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package/README.md

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+<div align="center">
+  <h1>medical-codes-mcp-server</h1>
+  <p><b>Decode, search, validate, and crosswalk US medical codes — ICD-10-CM, ICD-10-PCS, HCPCS Level II — over a bundled offline index via MCP. STDIO or Streamable HTTP.</b>
+  <div>6 Tools</div>
+  </p>
+</div>
+
+<div align="center">
+
+[![Version](https://img.shields.io/badge/Version-0.1.0-blue.svg?style=flat-square)](./CHANGELOG.md) [![License](https://img.shields.io/badge/License-Apache%202.0-orange.svg?style=flat-square)](./LICENSE) [![MCP SDK](https://img.shields.io/badge/MCP%20SDK-^1.29.0-green.svg?style=flat-square)](https://modelcontextprotocol.io/) [![npm](https://img.shields.io/npm/v/@cyanheads/medical-codes-mcp-server?style=flat-square&logo=npm&logoColor=white)](https://www.npmjs.com/package/@cyanheads/medical-codes-mcp-server) [![TypeScript](https://img.shields.io/badge/TypeScript-^6.0.3-3178C6.svg?style=flat-square)](https://www.typescriptlang.org/) [![Bun](https://img.shields.io/badge/Bun-v1.3-blueviolet.svg?style=flat-square)](https://bun.sh/)
+
+</div>
+
+<div align="center">
+
+[![Install in Cursor](https://cursor.com/deeplink/mcp-install-dark.svg)](https://cursor.com/en/install-mcp?name=medical-codes-mcp-server&config=eyJjb21tYW5kIjoibnB4IiwiYXJncyI6WyIteSIsIkBjeWFuaGVhZHMvbWVkaWNhbC1jb2Rlcy1tY3Atc2VydmVyIl19) [![Install in VS Code](https://img.shields.io/badge/VS_Code-Install_Server-0098FF?style=for-the-badge&logo=visualstudiocode&logoColor=white)](https://vscode.dev/redirect?url=vscode:mcp/install?%7B%22name%22%3A%22medical-codes-mcp-server%22%2C%22command%22%3A%22npx%22%2C%22args%22%3A%5B%22-y%22%2C%22%40cyanheads/medical-codes-mcp-server%22%5D%7D)
+
+</div>
+
+<div align="center">
+
+[![Framework](https://img.shields.io/badge/Built%20on-@cyanheads/mcp--ts--core-67E8F9?style=flat-square)](https://www.npmjs.com/package/@cyanheads/mcp-ts-core)
+
+</div>
+
+---
+
+> [!NOTE]
+> **Informational, not clinical or coding advice.** This server returns official code descriptions and billable/validity flags from public-domain federal releases to help you decode and look up codes. It is **not** medical advice, and a `valid_billable` result is **not** a coding or reimbursement decision. Always verify codes against the official source releases (CMS, CDC/NCHS, NLM) and your payer's rules before submitting a claim. The bundled data is only as current as the release baked into the build — call `medcode_list_systems` to see exactly which releases are active.
+
+## How it works
+
+The code data is **bundled inside the package** — a single SQLite + FTS5 database (`data/medical-codes.db`) built at package-build time from the canonical federal source files and shipped in the npm tarball and Docker image. The server opens it **read-only** at startup and answers every tool call from disk.
+
+That means the server is **offline, keyless, and deterministic**: no runtime network calls, no API key, no rate limit, single-tenant. The same inputs against the same bundled build always return the same output.
+
+### Bundled code systems
+
+Only freely-redistributable, public-domain US federal code sets are bundled:
+
+| System | Source | Covers |
+|:---|:---|:---|
+| **ICD-10-CM** | [CDC/NCHS](https://www.cdc.gov/nchs/icd/icd-10-cm/index.html) — US federal, public domain | Diagnoses (billable leaf codes + non-billable category headers) |
+| **ICD-10-PCS** | [CMS](https://www.cms.gov/medicare/coding-billing/icd-10-codes) — US federal, public domain | Inpatient procedures (axis-based 7-character codes) |
+| **HCPCS Level II** | [CMS](https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system) — US federal, public domain | Supplies, drugs, and non-physician services |
+
+**RxNorm** ([NLM](https://www.nlm.nih.gov/research/umls/rxnorm/), public domain) — the drug-crosswalk layer (drug name ↔ RXCUI ↔ NDC, ingredients, brands) — is **not bundled yet**; it lands in a later release. Until then, `medcode_map_codes`' drug directions return a `direction_unavailable` error, and the hierarchy directions (`parents`/`children`) work today.
+
+CPT (AMA copyright) and SNOMED CT / LOINC (UMLS-license-gated) are intentionally absent — they are not freely redistributable, so they cannot ship in an offline package.
+
+**US scope.** ICD-10-CM and ICD-10-PCS are the US clinical modifications, not the WHO ICD-10/ICD-11 base or another country's national modification.
+
+## Tools
+
+Six tools organized goal-first — one per user action, with a `system` discriminator instead of a per-system tool for each of the bundled code sets. All are read-only.
+
+| Tool | Description |
+|:---|:---|
+| `medcode_get_code` | Decode 1–50 codes to their official descriptions. Auto-detects the system per code; partial-success `found` / `notFound`. |
+| `medcode_search_codes` | Full-text search over official descriptions — go from a clinical description to the code. |
+| `medcode_check_code` | Validate a code's existence, currency, and billability, with a `whyNot` for non-billable/terminated cases. |
+| `medcode_map_codes` | Crosswalk a code within its hierarchy (`parents`/`children`); RxNorm drug directions land in a later release. |
+| `medcode_browse_hierarchy` | Walk a system's hierarchy for discovery without a search term. |
+| `medcode_list_systems` | List bundled systems with release identifiers, effective dates, and code counts (provenance). |
+
+### `medcode_get_code`
+
+Decode one or more codes seen in a claim, EHR field, or another health server's output. The 80% entry point.
+
+- Accepts 1–50 codes; mixed systems are fine — each code's system is detected independently from its shape
+- Partial success: resolved codes in `found`, unresolved in `notFound` with a per-code reason, so one bad code never fails the batch
+- An explicit `system` overrides auto-detection when a value is genuinely ambiguous (an ambiguous code lists its `candidateSystems`)
+- `includeHierarchy` attaches each code's parent and immediate children
+- The resolved `system` is echoed on every result for chaining into `medcode_map_codes` or a billability check
+
+---
+
+### `medcode_search_codes`
+
+Find codes whose official descriptions match a described concept — the reverse of `medcode_get_code`.
+
+- Every search term must appear (prefix-matched), so `"diabetic neuropathy"` returns codes mentioning both
+- Filter by `system`, `billableOnly` (exclude headers/categories), and `chapter`
+- Ranked by full-text relevance; results echo the resolved system per row
+- Discloses truncation when the result hits the cap, and returns an explicit notice (with the parsed query) when nothing matched
+
+---
+
+### `medcode_check_code`
+
+Validate whether a code is safe to submit, before a claim goes out.
+
+- Discriminated status: `valid_billable`, `valid_not_billable`, `valid_header`, or `terminated`
+- A `whyNot` string explains the non-billable and terminated cases (e.g. "valid ICD-10-CM category but not billable — submit a more specific child code")
+- Validity vs. existence is split: a non-billable or terminated code is a **successful** result with a `whyNot`, not an error — only a code absent from every bundled system raises `unknown_code`
+
+---
+
+### `medcode_map_codes`
+
+Crosswalk a code across systems and within a hierarchy.
+
+- Hierarchy directions (available now): `parents` and `children` walk a code's prefix hierarchy (ICD-10-CM / HCPCS; ICD-10-PCS codes have no prefix parent)
+- Drug directions (`name_to_rxcui`, `ndc_to_rxcui`, `rxcui_to_ndc`, `rxcui_to_ingredients`, `rxcui_to_brands`) are RxNorm-backed and return `direction_unavailable` until RxNorm is bundled in a later release
+- Every result carries `source` provenance (which system or edge answered) so a chained call uses the right identifier
+
+---
+
+### `medcode_browse_hierarchy`
+
+Orient in an unfamiliar system or enumerate a category's specific codes, without a search term.
+
+- With no `node`: top-level entries (ICD-10-CM categories, HCPCS range buckets, or ICD-10-PCS first-axis values)
+- With a `node`: its immediate children
+- ICD-10-CM and HCPCS use a prefix hierarchy (a shorter code is the parent of a longer one); ICD-10-PCS is axis-based — each of the 7 characters is an independent axis, so browsing returns valid next-position axis values, not prefix children
+
+## Features
+
+Built on [`@cyanheads/mcp-ts-core`](https://www.npmjs.com/package/@cyanheads/mcp-ts-core):
+
+- Declarative tool definitions — single file per tool, framework handles registration and validation
+- Unified error handling — handlers throw, framework catches, classifies, and formats
+- Typed per-tool error contracts — capable clients preview failure modes from `tools/list`
+- Structured logging with optional OpenTelemetry tracing
+- STDIO and Streamable HTTP transports
+
+Domain-specific:
+
+- Bundled SQLite + FTS5 index — offline, keyless, deterministic; no runtime network I/O, no rate limit
+- Code-shape auto-detection routes a code to its system; an explicit `system` disambiguates collisions
+- Real billable/validity signal from the source releases — the order-file billable flag drives `medcode_check_code`, not a heuristic
+
+Agent-friendly output:
+
+- Provenance on every response — the resolved `system` is echoed for chaining, and `medcode_list_systems` reports exactly which release is baked into the running build
+- Graceful partial failure — `medcode_get_code` returns per-code `found` / `notFound` rows instead of failing the batch
+- Discriminated output contracts — `medcode_check_code`'s typed status and `medcode_map_codes`' `source` let callers branch on data, not string parsing
+
+## Getting started
+
+This server ships with the code database bundled — there is no API key to obtain and nothing to download at runtime. Add the following to your MCP client configuration file.
+
+```json
+{
+  "mcpServers": {
+    "medical-codes-mcp-server": {
+      "type": "stdio",
+      "command": "bunx",
+      "args": ["@cyanheads/medical-codes-mcp-server@latest"],
+      "env": {
+        "MCP_TRANSPORT_TYPE": "stdio",
+        "MCP_LOG_LEVEL": "info"
+      }
+    }
+  }
+}
+```
+
+Or with npx (no Bun required):
+
+```json
+{
+  "mcpServers": {
+    "medical-codes-mcp-server": {
+      "type": "stdio",
+      "command": "npx",
+      "args": ["-y", "@cyanheads/medical-codes-mcp-server@latest"],
+      "env": {
+        "MCP_TRANSPORT_TYPE": "stdio",
+        "MCP_LOG_LEVEL": "info"
+      }
+    }
+  }
+}
+```
+
+Or with Docker:
+
+```json
+{
+  "mcpServers": {
+    "medical-codes-mcp-server": {
+      "type": "stdio",
+      "command": "docker",
+      "args": [
+        "run", "-i", "--rm",
+        "-e", "MCP_TRANSPORT_TYPE=stdio",
+        "ghcr.io/cyanheads/medical-codes-mcp-server:latest"
+      ]
+    }
+  }
+}
+```
+
+For Streamable HTTP, set the transport and start the server:
+
+```sh
+MCP_TRANSPORT_TYPE=http MCP_HTTP_PORT=3010 bun run start:http
+# Server listens at http://localhost:3010/mcp
+```
+
+Refer to "your MCP client configuration file" generically — different clients use different config paths, and the server isn't client-specific.
+
+### Prerequisites
+
+- [Bun v1.3](https://bun.sh/) or higher (or Node.js v24+ — the server falls back to the `better-sqlite3` optional dependency when not run under Bun).
+- No API key, account, or network access required.
+
+### Installation
+
+1. **Clone the repository:**
+
+```sh
+git clone https://github.com/cyanheads/medical-codes-mcp-server.git
+```
+
+2. **Navigate into the directory:**
+
+```sh
+cd medical-codes-mcp-server
+```
+
+3. **Install dependencies:**
+
+```sh
+bun install
+```
+
+4. **Configure environment (optional):**
+
+```sh
+cp .env.example .env
+# all runtime vars are optional — the server runs as-is
+```
+
+## Configuration
+
+The server is offline and keyless — there are no required variables. Two server-specific knobs and the standard framework vars apply:
+
+| Variable | Description | Default |
+|:---|:---|:---|
+| `MEDCODE_DB_PATH` | Absolute path override for the bundled SQLite index. Set only to point at a custom-built or externally-mounted database. | packaged `data/medical-codes.db` |
+| `MEDCODE_MAX_RESULTS` | Cap on rows returned by `medcode_search_codes` / `medcode_browse_hierarchy`. | `50` (ceiling `200`) |
+| `MCP_TRANSPORT_TYPE` | Transport: `stdio` or `http`. | `stdio` |
+| `MCP_HTTP_PORT` | Port for the HTTP server. | `3010` |
+| `MCP_HTTP_ENDPOINT_PATH` | Endpoint path where the MCP server is mounted. | `/mcp` |
+| `MCP_AUTH_MODE` | Auth mode: `none`, `jwt`, or `oauth`. | `none` |
+| `MCP_LOG_LEVEL` | Log level (RFC 5424). | `info` |
+| `OTEL_ENABLED` | Enable [OpenTelemetry instrumentation](https://github.com/cyanheads/mcp-ts-core/tree/main/docs/telemetry). | `false` |
+
+See [`.env.example`](./.env.example) for the full list of optional overrides.
+
+## Running the server
+
+### Local development
+
+- **Build and run:**
+
+  ```sh
+  # One-time build
+  bun run rebuild
+
+  # Run the built server
+  bun run start:stdio
+  # or
+  bun run start:http
+  ```
+
+- **Run checks and tests:**
+
+  ```sh
+  bun run devcheck   # Lint, format, typecheck, security
+  bun run test       # Vitest test suite
+  bun run lint:mcp   # Validate MCP definitions against spec
+  ```
+
+### Building the bundled index
+
+The bundled `data/medical-codes.db` is committed and shipped — you only rebuild it when refreshing to a new federal release:
+
+```sh
+bun run scripts/build-index.ts
+```
+
+The script downloads the canonical `.gov` source files, parses them (ICD-10-CM/PCS order files, HCPCS `ANWEB.txt`), and emits the single `.db` file. It runs at build time only — the server never downloads anything.
+
+### Docker
+
+```sh
+docker build -t medical-codes-mcp-server .
+docker run --rm -e MCP_TRANSPORT_TYPE=stdio medical-codes-mcp-server
+```
+
+The Dockerfile defaults to HTTP transport, stateless session mode, and logs to `/var/log/medical-codes-mcp-server`. It copies the bundled `data/medical-codes.db` into the image so the server is fully self-contained. OpenTelemetry peer dependencies are installed by default — build with `--build-arg OTEL_ENABLED=false` to omit them.
+
+## Project structure
+
+| Directory | Purpose |
+|:---|:---|
+| `src/index.ts` | `createApp()` entry point — registers the six tools and opens the bundled index in `setup()`. |
+| `src/config` | Server-specific environment variable parsing and validation with Zod. |
+| `src/mcp-server/tools` | Tool definitions (`*.tool.ts`). |
+| `src/services/code-index` | The code-index service — read-only SQLite handle, code-shape detection, FTS5 query translation. |
+| `scripts/build-index.ts` | Build-time ingest pipeline that bakes the federal source files into `data/medical-codes.db`. |
+| `data/medical-codes.db` | The bundled SQLite + FTS5 code index, opened read-only at runtime. |
+| `tests/` | Unit and integration tests mirroring `src/`. |
+
+## Development guide
+
+See [`CLAUDE.md`/`AGENTS.md`](./CLAUDE.md) for development guidelines and architectural rules. The short version:
+
+- Handlers throw, framework catches — no `try/catch` in tool logic
+- Use `ctx.log` for request-scoped logging; the code index is a read-only global, not tenant state
+- Register new tools via the `createApp()` array in `src/index.ts`
+- The bundled DB is the source of truth — surface real billable/validity flags from the source releases; never fabricate a code or a billability decision
+
+## Contributing
+
+Issues and pull requests are welcome. Run checks and tests before submitting:
+
+```sh
+bun run devcheck
+bun run test
+```
+
+## License
+
+Apache-2.0 — see [LICENSE](./LICENSE) for details.

package/changelog/0.1.x/0.1.0.md

@@ -0,0 +1,24 @@
+---
+summary: "Offline US medical code lookup and crosswalk over a bundled SQLite+FTS5 index: ICD-10-CM, ICD-10-PCS, and HCPCS Level II across six medcode_* tools (RxNorm in a later release)."
+breaking: false
+security: false
+---
+
+# 0.1.0 — 2026-06-13
+
+Initial release. Indexes the freely-redistributable US federal code sets into one offline, keyless, deterministic lookup-and-crosswalk server backed by a bundled SQLite + FTS5 database built at package-build time. v1 bundles ICD-10-CM, ICD-10-PCS, and HCPCS Level II; RxNorm (drug crosswalks) lands in a later release.
+
+## Added
+
+- **Six `medcode_*` tools**, all read-only (`readOnlyHint`, `idempotentHint`, `openWorldHint: false`):
+  - **`medcode_get_code`** — decode 1–50 codes to official descriptions; auto-detects the system per code, partial-success `found` / `notFound`, optional `includeHierarchy` for parent + immediate children.
+  - **`medcode_search_codes`** — FTS5 description search (every term required, prefix-matched), filterable by `system` / `billableOnly` / `chapter`, with truncation disclosure and empty-result notice.
+  - **`medcode_check_code`** — validity status (`valid_billable` / `valid_not_billable` / `valid_header` / `terminated`) with a `whyNot`; the validity-vs-existence split means a non-billable or terminated code is a successful result, not an error.
+  - **`medcode_map_codes`** — crosswalk `parents` / `children` now; RxNorm drug directions (`name_to_rxcui`, `ndc_to_rxcui`, `rxcui_to_ndc`, `rxcui_to_ingredients`, `rxcui_to_brands`) raise `direction_unavailable` until RxNorm is bundled.
+  - **`medcode_browse_hierarchy`** — prefix hierarchy for ICD-10-CM/HCPCS, axis-value browse for ICD-10-PCS.
+  - **`medcode_list_systems`** — release identifiers, effective dates, and code counts for provenance.
+- **`code-index` service** — opens the bundled database read-only at startup (`bun:sqlite` under Bun, `better-sqlite3` under Node), fails fast on a missing or empty index, and owns code-shape detection and FTS5 query translation.
+- **`scripts/build-index.ts`** — build-time ingest pipeline that parses the canonical federal source files (ICD-10-CM/PCS order files, HCPCS `ANWEB.txt`, RxNorm Prescribable RRF) into the bundled `.db`. Never downloads at runtime; never pulls the full RxNorm release (Prescribable subset only, to preserve redistribution).
+- **`scripts/build-fixture-db.ts`** — generates the small synthetic `data/medical-codes.db` the test suite and local smoke runs exercise.
+- **Server config** — `MEDCODE_DB_PATH` (bundled-DB path override) and `MEDCODE_MAX_RESULTS` (search/browse cap, default 50, ceiling 200).
+- **`better-sqlite3`** optional dependency — Node-runtime SQLite driver; Bun uses the built-in `bun:sqlite`.