hccinfhir 0.0.3__py3-none-any.whl → 0.0.5__py3-none-any.whl

hccinfhir/model_hierarchies.py

@@ -0,0 +1,70 @@
+from typing import Dict, Set, Tuple
+import importlib.resources
+from hccinfhir.datamodels import ModelName  
+
+# Load default mappings from csv file
+hierarchies_file_default = 'ra_hierarchies_2025.csv'
+hierarchies_default: Dict[Tuple[str, ModelName], Set[str]] = {}  # (diagnosis_code, model_name) -> {cc}
+
+try:
+    with importlib.resources.open_text('hccinfhir.data', hierarchies_file_default) as f:
+        for line in f.readlines()[1:]:  # Skip header
+            try:
+                cc_parent, cc_child, model_domain, model_version, _ = line.strip().split(',')
+                if model_domain == 'ESRD':
+                    model_name = f"CMS-HCC {model_domain} Model {model_version}"
+                else:
+                    model_name = f"{model_domain} Model {model_version}"
+                key = (cc_parent, model_name)
+                if key not in hierarchies_default:
+                    hierarchies_default[key] = {cc_child}
+                else:
+                    hierarchies_default[key].add(cc_child)
+            except ValueError:
+                continue  # Skip malformed lines
+except Exception as e:
+    print(f"Error loading mapping file: {e}")
+    hierarchies_default = {}
+
+def apply_hierarchies(
+    cc_set: Set[str],  # Set of active CCs
+    model_name: ModelName = "CMS-HCC Model V28",
+    hierarchies: Dict[Tuple[str, ModelName], Set[str]] = hierarchies_default
+) -> Set[str]:
+    """
+    Apply hierarchical rules to a set of CCs based on model version.
+
+    Args:
+        ccs: Set of current active CCs
+        model_name: HCC model name to use for hierarchy rules
+        hierarchies: Optional custom hierarchy dictionary
+        
+    Returns:
+        Set of CCs after applying hierarchies
+    """
+    # Track CCs that should be zeroed out
+    to_remove = set()
+    
+    # For V28, if none of 221, 222, 224, 225, 226 are present, remove 223
+    if model_name == "CMS-HCC Model V28":
+        if ("223" in cc_set and 
+            not any(cc in cc_set for cc in ["221", "222", "224", "225", "226"])):
+            cc_set.remove("223")
+    elif model_name == "CMS-HCC ESRD Model V21":
+        if "134" in cc_set:
+            cc_set.remove("134")
+    elif model_name == "CMS-HCC ESRD Model V24":
+        for cc in ["134", "135", "136", "137"]:
+            if cc in cc_set:
+                cc_set.remove(cc)
+
+    # Apply hierarchies
+    for cc in cc_set:
+        hierarchy_key = (cc, model_name)
+        if hierarchy_key in hierarchies:
+            # If parent CC exists, remove all child CCs
+            child_ccs = hierarchies[hierarchy_key]
+            to_remove.update(child_ccs & cc_set)
+
+    # Return CCs with hierarchical exclusions removed
+    return cc_set - to_remove

hccinfhir/model_interactions.py

@@ -0,0 +1,342 @@
+from hccinfhir.datamodels import Demographics, ModelName
+from typing import Optional
+
+def has_any_hcc(hcc_list: list[str], hcc_set: set[str]) -> int:
+    """Returns 1 if any HCC in the list is present, 0 otherwise"""
+    return int(bool(set(hcc_list) & hcc_set))
+
+def create_demographic_interactions(demographics: Demographics) -> dict:
+    """Creates common demographic-based interactions"""
+    interactions = {}
+    is_female = demographics.category.startswith('F')
+    is_male = demographics.category.startswith('M')
+    is_aged = not demographics.non_aged
+    
+    # Original Disability interactions
+    if is_aged:
+        interactions['OriginallyDisabled_Female'] = int(demographics.orig_disabled) * int(is_female)
+        interactions['OriginallyDisabled_Male'] = int(demographics.orig_disabled) * int(is_male)
+    else:
+        interactions['OriginallyDisabled_Female'] = 0
+        interactions['OriginallyDisabled_Male'] = 0
+
+    # LTI interactions - used for ESRD models
+    if demographics.lti:
+        interactions['LTI_Aged'] = int(is_aged)
+        interactions['LTI_NonAged'] = int(not is_aged)
+    else:
+        interactions['LTI_Aged'] = 0
+        interactions['LTI_NonAged'] = 0
+        
+    nemcaid = False
+    if demographics.new_enrollee and demographics.dual_elgbl_cd in {'01', '02', '03', '04', '05', '06', '08'}:
+        nemcaid = True
+    ne_origds = int(demographics.age >= 65 and (demographics.orec is not None and demographics.orec == "1"))
+    
+    # Four mutually exclusive groups
+    interactions.update({
+        f'NMCAID_NORIGDIS_{demographics.category}': int(not nemcaid and not ne_origds),
+        f'MCAID_NORIGDIS_{demographics.category}': int(nemcaid and not ne_origds),
+        f'NMCAID_ORIGDIS_{demographics.category}': int(not nemcaid and ne_origds),
+        f'MCAID_ORIGDIS_{demographics.category}': int(nemcaid and ne_origds)
+    })
+
+    return interactions
+
+def create_dual_interactions(demographics: Demographics) -> dict:
+    """Creates dual status interactions"""
+    interactions = {}
+    is_female = demographics.category.startswith('F')
+    is_male = demographics.category.startswith('M')
+    is_aged = not demographics.non_aged
+    
+    if demographics.fbd:
+        interactions.update({
+            'FBDual_Female_Aged': int(is_female) * int(is_aged),
+            'FBDual_Female_NonAged': int(is_female) * int(not is_aged),
+            'FBDual_Male_Aged': int(is_male) * int(is_aged),
+            'FBDual_Male_NonAged': int(is_male) * int(not is_aged)
+        })
+    
+    if demographics.pbd:
+        interactions.update({
+            'PBDual_Female_Aged': int(is_female) * int(is_aged),
+            'PBDual_Female_NonAged': int(is_female) * int(not is_aged),
+            'PBDual_Male_Aged': int(is_male) * int(is_aged),
+            'PBDual_Male_NonAged': int(is_male) * int(not is_aged)
+        })
+        
+    return interactions
+
+def create_hcc_counts(hcc_set: set[str]) -> dict:
+    """Creates HCC count variables"""
+    counts = {}
+    hcc_count = len(hcc_set)
+    
+    for i in range(1, 10):
+        counts[f'D{i}'] = int(hcc_count == i)
+    counts['D10P'] = int(hcc_count >= 10)
+    
+    return counts
+
+def get_diagnostic_categories(model_name: ModelName, hcc_set: set[str]) -> dict:
+    """Creates disease categories based on model version"""
+    if model_name == "CMS-HCC Model V28":
+        return {
+            'CANCER_V28': has_any_hcc(['17', '18', '19', '20', '21', '22', '23'], hcc_set),
+            'DIABETES_V28': has_any_hcc(['35', '36', '37', '38'], hcc_set),
+            'CARD_RESP_FAIL_V28': has_any_hcc(['211', '212', '213'], hcc_set),
+            'HF_V28': has_any_hcc(['221', '222', '223', '224', '225', '226'], hcc_set),
+            'CHR_LUNG_V28': has_any_hcc(['276', '277', '278', '279', '280'], hcc_set),
+            'KIDNEY_V28': has_any_hcc(['326', '327', '328', '329'], hcc_set),
+            'SEPSIS_V28': int('2' in hcc_set),
+            'gSubUseDisorder_V28': has_any_hcc(['135', '136', '137', '138', '139'], hcc_set),
+            'gPsychiatric_V28': has_any_hcc(['151', '152', '153', '154', '155'], hcc_set),
+            'NEURO_V28': has_any_hcc(['180', '181', '182', '190', '191', '192', '195', '196', '198', '199'], hcc_set),
+            'ULCER_V28': has_any_hcc(['379', '380', '381', '382'], hcc_set)
+        }
+    elif model_name == "CMS-HCC Model V24":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),
+            'gCopdCF': has_any_hcc(['110', '111', '112'], hcc_set),
+            'RENAL_V24': has_any_hcc(['134', '135', '136', '137', '138'], hcc_set), 
+            'SEPSIS': int('2' in hcc_set),
+            'gSubstanceUseDisorder_V24': has_any_hcc(['54', '55', '56'], hcc_set),
+            'gPsychiatric_V24': has_any_hcc(['57', '58', '59', '60'], hcc_set),
+            'PRESSURE_ULCER': has_any_hcc(['157', '158', '159'],  hcc_set) # added in 2018-11-20
+        }
+    elif model_name == "CMS-HCC Model V22":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),
+            'gCopdCF': has_any_hcc(['110', '111', '112'], hcc_set),
+            'RENAL': has_any_hcc(['134', '135', '136', '137'], hcc_set), 
+            'SEPSIS': int('2' in hcc_set),
+            'gSubstanceUseDisorder': has_any_hcc(['54', '55'], hcc_set),
+            'gPsychiatric': has_any_hcc(['57', '58'], hcc_set),
+            'PRESSURE_ULCER': has_any_hcc(['157', '158'],  hcc_set) # added in 2012-10-19
+        }
+    elif model_name == "CMS-HCC ESRD Model V24":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),            
+            'gCopdCF': has_any_hcc(['110', '111', '112'], hcc_set),
+            'RENAL_V24': has_any_hcc(['134', '135', '136', '137', '138'], hcc_set),
+            'SEPSIS': int('2' in hcc_set),
+            'PRESSURE_ULCER': has_any_hcc(['157', '158', '159', '160'], hcc_set), # added in 2018-11-20
+            'gSubstanceUseDisorder_V24': has_any_hcc(['54', '55', '56'], hcc_set),
+            'gPsychiatric_V24': has_any_hcc(['57', '58', '59', '60'], hcc_set)
+        }
+    elif model_name == "CMS-HCC ESRD Model V21":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'IMMUNE': int('47' in hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),
+            'COPD': has_any_hcc(['110', '111'], hcc_set),
+            'RENAL': has_any_hcc(['134', '135', '136', '137', '138', '139', '140', '141'], hcc_set),
+            'COMPL': int('176' in hcc_set),
+            'SEPSIS': int('2' in hcc_set), 
+            'PRESSURE_ULCER': has_any_hcc(['157', '158', '159', '160'], hcc_set)
+        }
+    elif model_name == "RxHCC Model V08":
+        # RxModel doesn't seem to have any diagnostic category interactions
+        return {}
+    return {}
+
+def create_disease_interactions(model_name: ModelName, 
+                              diagnostic_cats: dict, 
+                              demographics: Optional[Demographics],
+                              hcc_set: Optional[set[str]]) -> dict:
+    """Creates disease interaction variables based on model version.
+    
+    Args:
+        model_name: The HCC model version being used
+        diagnostic_cats: Dictionary of diagnostic categories
+        demographics: Optional demographic information for age/sex/disability interactions
+        hcc_set: Optional set of HCCs for direct HCC checks
+        
+    Returns:
+        Dictionary containing all disease interaction variables
+    """
+    interactions = {}
+    
+    if model_name == "CMS-HCC Model V28":
+        # Base V28 disease interactions
+        interactions.update({
+            'DIABETES_HF_V28': diagnostic_cats['DIABETES_V28'] * diagnostic_cats['HF_V28'],
+            'HF_CHR_LUNG_V28': diagnostic_cats['HF_V28'] * diagnostic_cats['CHR_LUNG_V28'],
+            'HF_KIDNEY_V28': diagnostic_cats['HF_V28'] * diagnostic_cats['KIDNEY_V28'],
+            'CHR_LUNG_CARD_RESP_FAIL_V28': diagnostic_cats['CHR_LUNG_V28'] * diagnostic_cats['CARD_RESP_FAIL_V28'],
+            'gSubUseDisorder_gPsych_V28': diagnostic_cats['gSubUseDisorder_V28'] * diagnostic_cats['gPsychiatric_V28'],
+            'DISABLED_CANCER_V28': demographics.disabled * diagnostic_cats['CANCER_V28'],
+            'DISABLED_NEURO_V28': demographics.disabled * diagnostic_cats['NEURO_V28'],
+            'DISABLED_HF_V28': demographics.disabled * diagnostic_cats['HF_V28'],
+            'DISABLED_CHR_LUNG_V28': demographics.disabled * diagnostic_cats['CHR_LUNG_V28'],
+            'DISABLED_ULCER_V28': demographics.disabled * diagnostic_cats['ULCER_V28']
+        })
+            
+    elif model_name == "CMS-HCC Model V24":
+        # Base V24/V22 disease interactions
+        interactions.update({
+            'HCC47_gCancer': int('47' in hcc_set) * diagnostic_cats['CANCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_gCopdCF': diagnostic_cats['CHF'] * diagnostic_cats['gCopdCF'],
+            'HCC85_gRenal_V24': diagnostic_cats['CHF'] * diagnostic_cats['RENAL_V24'],
+            'gCopdCF_CARD_RESP_FAIL': diagnostic_cats['gCopdCF'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'HCC85_HCC96': int('85' in hcc_set) * int('96' in hcc_set),
+            'gSubstanceAbuse_gPsych': diagnostic_cats['gSubstanceUseDisorder_V24'] * diagnostic_cats['gPsychiatric_V24'],
+            'SEPSIS_PRESSURE_ULCER': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESS_ULCER': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'gCopdCF_ASP_SPEC_B_PNEUM': diagnostic_cats['gCopdCF'] * int('114' in hcc_set),
+            'ASP_SPEC_B_PNEUM_PRES_ULC': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_gCopdCF': int('57' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'DISABLED_HCC85': demographics.disabled * int('85' in hcc_set),
+            'DISABLED_PRESSURE_ULCER': demographics.disabled * diagnostic_cats['PRESSURE_ULCER'],
+            'DISABLED_HCC161': demographics.disabled * int('161' in hcc_set),
+            'DISABLED_HCC39': demographics.disabled * int('39' in hcc_set),
+            'DISABLED_HCC77': demographics.disabled * int('77' in hcc_set),
+            'DISABLED_HCC6': demographics.disabled * int('6' in hcc_set)
+        })
+    elif model_name == "CMS-HCC Model V22":
+        # Base V24/V22 disease interactions
+        interactions.update({
+            'HCC47_gCancer': int('47' in hcc_set) * diagnostic_cats['CANCER'],
+            'HCC85_gDiabetesMellitus': int('85' in hcc_set) * diagnostic_cats['DIABETES'],
+            'HCC85_gCopdCF': int('85' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'HCC85_gRenal': int('85' in hcc_set) * diagnostic_cats['RENAL'],
+            'gRespDepandArre_gCopdCF': diagnostic_cats['CARD_RESP_FAIL'] * diagnostic_cats['gCopdCF'],
+            'HCC85_HCC96': int('85' in hcc_set) * int('96' in hcc_set),
+            'gSubstanceAbuse_gPsychiatric': diagnostic_cats['gSubstanceUseDisorder'] * diagnostic_cats['gPsychiatric'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_gCopdCF': diagnostic_cats['CHF'] * diagnostic_cats['gCopdCF'],
+            'gCopdCF_CARD_RESP_FAIL': diagnostic_cats['gCopdCF'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'SEPSIS_PRESSURE_ULCER': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESSURE_ULCER': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'gCopdCF_ASP_SPEC_BACT_PNEUM': diagnostic_cats['gCopdCF'] * int('114' in hcc_set),
+            'ASP_SPEC_BACT_PNEUM_PRES_ULC': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_gCopdCF': int('57' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'DISABLED_HCC85': demographics.disabled * int('85' in hcc_set),
+            'DISABLED_PRESSURE_ULCER': demographics.disabled * diagnostic_cats['PRESSURE_ULCER'],
+            'DISABLED_HCC161': demographics.disabled * int('161' in hcc_set),
+            'DISABLED_HCC39': demographics.disabled * int('39' in hcc_set),
+            'DISABLED_HCC77': demographics.disabled * int('77' in hcc_set),
+            'DISABLED_HCC6': demographics.disabled * int('6' in hcc_set)
+        })
+    elif model_name == "CMS-HCC ESRD Model V24":
+        # Base ESRD V24 disease interactions
+        interactions.update({
+            'HCC47_gCancer': int('47' in hcc_set) * diagnostic_cats['CANCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_gCopdCF': diagnostic_cats['CHF'] * diagnostic_cats['gCopdCF'],
+            'HCC85_gRenal_V24': int('85' in hcc_set) * diagnostic_cats['RENAL_V24'],
+            'gCopdCF_CARD_RESP_FAIL': diagnostic_cats['gCopdCF'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'HCC85_HCC96': int('85' in hcc_set) * int('96' in hcc_set),
+            'gSubUseDs_gPsych_V24': diagnostic_cats['gSubstanceUseDisorder_V24'] * diagnostic_cats['gPsychiatric_V24'],
+            'NONAGED_gSubUseDs_gPsych': demographics.non_aged * (diagnostic_cats['gSubstanceUseDisorder_V24'] * diagnostic_cats['gPsychiatric_V24']),
+            'NONAGED_HCC6': demographics.non_aged * int('6' in hcc_set),
+            'NONAGED_HCC34': demographics.non_aged * int('34' in hcc_set),
+            'NONAGED_HCC46': demographics.non_aged * int('46' in hcc_set),
+            'NONAGED_HCC110': demographics.non_aged * int('110' in hcc_set),
+            'NONAGED_HCC176': demographics.non_aged * int('176' in hcc_set),
+            'SEPSIS_PRESSURE_ULCER_V24': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESS_ULCER_V24': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'gCopdCF_ASP_SPEC_B_PNEUM': diagnostic_cats['gCopdCF'] * int('114' in hcc_set),
+            'ASP_SPEC_B_PNEUM_PRES_ULC_V24': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_gCopdCF': int('57' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'NONAGED_HCC85': demographics.non_aged * int('85' in hcc_set),
+            'NONAGED_PRESSURE_ULCER_V24': demographics.non_aged * diagnostic_cats['PRESSURE_ULCER'],
+            'NONAGED_HCC161': demographics.non_aged * int('161' in hcc_set),
+            'NONAGED_HCC39': demographics.non_aged * int('39' in hcc_set),
+            'NONAGED_HCC77': demographics.non_aged * int('77' in hcc_set)
+        })
+    
+    elif model_name == 'CMS-HCC ESRD Model V21':
+        # ESRD Community model interactions
+        interactions.update({
+            'SEPSIS_CARD_RESP_FAIL': diagnostic_cats['SEPSIS'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'CANCER_IMMUNE': diagnostic_cats['CANCER'] * diagnostic_cats['IMMUNE'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_COPD': diagnostic_cats['CHF'] * diagnostic_cats['COPD'],
+            'CHF_RENAL': diagnostic_cats['CHF'] * diagnostic_cats['RENAL'],
+            'COPD_CARD_RESP_FAIL': diagnostic_cats['COPD'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'NONAGED_HCC6': demographics.non_aged * int('6' in hcc_set),
+            'NONAGED_HCC34': demographics.non_aged * int('34' in hcc_set),
+            'NONAGED_HCC46': demographics.non_aged * int('46' in hcc_set),
+            'NONAGED_HCC54': demographics.non_aged * int('54' in hcc_set),
+            'NONAGED_HCC55': demographics.non_aged * int('55' in hcc_set),
+            'NONAGED_HCC110': demographics.non_aged * int('110' in hcc_set),
+            'NONAGED_HCC176': demographics.non_aged * int('176' in hcc_set),
+            'SEPSIS_PRESSURE_ULCER': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESSURE_ULCER': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'COPD_ASP_SPEC_BACT_PNEUM': diagnostic_cats['COPD'] * int('114' in hcc_set),
+            'ASP_SPEC_BACT_PNEUM_PRES_ULC': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_COPD': int('57' in hcc_set) * diagnostic_cats['COPD'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'NONAGED_HCC85': demographics.non_aged * int('85' in hcc_set),
+            'NONAGED_PRESSURE_ULCER': demographics.non_aged * diagnostic_cats['PRESSURE_ULCER'],
+            'NONAGED_HCC161': demographics.non_aged * int('161' in hcc_set),
+            'NONAGED_HCC39': demographics.non_aged * int('39' in hcc_set),
+            'NONAGED_HCC77': demographics.non_aged * int('77' in hcc_set)
+        })
+            
+    elif model_name == "RxHCC Model V08":
+        # RxHCC NonAged interactions
+        interactions.update({
+            'NonAged_RXHCC1': demographics.non_aged * int('1' in hcc_set),
+            'NonAged_RXHCC130': demographics.non_aged * int('130' in hcc_set),
+            'NonAged_RXHCC131': demographics.non_aged * int('131' in hcc_set),
+            'NonAged_RXHCC132': demographics.non_aged * int('132' in hcc_set),
+            'NonAged_RXHCC133': demographics.non_aged * int('133' in hcc_set),
+            'NonAged_RXHCC159': demographics.non_aged * int('159' in hcc_set),
+            'NonAged_RXHCC163': demographics.non_aged * int('163' in hcc_set)
+        })
+    
+    return interactions
+
+def apply_interactions(demographics: Demographics, 
+                      hcc_set: set[str], 
+                      model_name: ModelName = "CMS-HCC Model V28") -> dict:
+    """
+    Calculate HCC interactions across CMS models. Handles CMS-HCC, ESRD, and RxHCC models.
+    """
+    # Start with demographic interactions
+    interactions = create_demographic_interactions(demographics)
+    
+    # Add dual status interactions
+    interactions.update(create_dual_interactions(demographics))
+    
+    # Get diagnostic categories for the model
+    diagnostic_cats = get_diagnostic_categories(model_name, hcc_set)
+    
+    interactions.update(create_disease_interactions(model_name, diagnostic_cats, demographics, hcc_set))
+        
+    # Add HCC counts
+    interactions.update(create_hcc_counts(hcc_set))
+    
+    return interactions

hccinfhir/samples/__init__.py

@@ -0,0 +1,2 @@
+# Empty file to make the package importable
+

hccinfhir/utils.py

@@ -0,0 +1,51 @@
+from typing import Set, Dict, Tuple
+import importlib.resources
+from hccinfhir.datamodels import ModelName, ProcFilteringFilename, DxCCMappingFilename
+
+def load_proc_filtering(filename: ProcFilteringFilename) -> Set[str]:
+    """
+    Load a single-column CSV file into a set of strings.
+    
+    Args:
+        filename: Name of the CSV file in the hccinfhir.data package
+        
+    Returns:
+        Set of strings from the CSV file
+    """
+    try:
+        with importlib.resources.open_text('hccinfhir.data', filename) as f:
+            return set(f.read().splitlines())
+    except Exception as e:
+        print(f"Error loading {filename}: {e}")
+        return set()
+
+def load_dx_to_cc_mapping(filename: DxCCMappingFilename) -> Dict[Tuple[str, ModelName], Set[str]]:
+    """
+    Load diagnosis to CC mapping from a CSV file.
+    Expected format: diagnosis_code,cc,model_name
+    
+    Args:
+        filename: Name of the CSV file in the hccinfhir.data package
+        
+    Returns:
+        Dictionary mapping (diagnosis_code, model_name) to a set of CC codes
+    """
+    mapping: Dict[Tuple[str, ModelName], Set[str]] = {}
+    
+    try:
+        with importlib.resources.open_text('hccinfhir.data', filename) as f:
+            for line in f.readlines()[1:]:  # Skip header
+                try:
+                    diagnosis_code, cc, model_name = line.strip().split(',')
+                    key = (diagnosis_code, model_name)
+                    if key not in mapping:
+                        mapping[key] = {cc}
+                    else:
+                        mapping[key].add(cc)
+                except ValueError:
+                    continue  # Skip malformed lines
+    except Exception as e:
+        print(f"Error loading mapping file: {e}")
+        return {}
+    
+    return mapping 

{hccinfhir-0.0.3.dist-info → hccinfhir-0.0.5.dist-info}/METADATA

@@ -1,6 +1,6 @@
 Metadata-Version: 2.3
 Name: hccinfhir
-Version: 0.0.3
+Version: 0.0.5
 Summary: HCC Algorithm for FHIR Resources
 Project-URL: Homepage, https://github.com/mimilabs/hccinfhir
 Project-URL: Issues, https://github.com/mimilabs/hccinfhir/issues
@@ -20,6 +20,9 @@ A Python library for extracting standardized service-level data from FHIR Explan
 - Support for both BCDA (Blue Button 2.0) and standard FHIR R4 formats
 - Pydantic models for type safety and data validation
 - Standardized Service Level Data (SLD) output format
+- Multiple HCC model support (V22, V24, V28, ESRD V21, ESRD V24, RxHCC V08)
+- Flexible input options: FHIR EOBs, service data, or direct diagnosis codes
+
 
 ## Installation
 ```bash
@@ -45,7 +48,26 @@ sld = [{
 }, ...]
 ```
 
-For more details on the SLD format, see the `models.py` file.
+Or, for direct risk score calculation from a list of diagnosis codes, you only need the model name, diagnosis codes, and basic demographic factors:
+
+```python
+from hccinfhir.model_calculate import calculate_raf
+
+diagnosis_codes = ['E119', 'I509']  # Diabetes without complications, Heart failure
+age = 67
+sex = 'F'
+model_name = "CMS-HCC Model V24"
+
+result = calculate_raf(
+   diagnosis_codes=diagnosis_codes,
+   model_name=model_name,
+   age=age,
+   sex=sex
+)
+```
+
+
+For more details on the SLD format, see the `datamodels.py` file.
 
 ## Core Components
 
@@ -71,23 +93,99 @@ filtered_sld = apply_filter(sld_list)
 ```
 
 
-### 3. Logic Module (In Development)
+### 3. Logic Module 
 Implements core HCC calculation logic:
 - Maps diagnosis codes to HCC categories
 - Applies hierarchical rules and interactions
 - Calculates final RAF scores
 - Integrates with standard CMS data files
 
-## Usage
 ```python
-from hccinfhir import HCCInFHIR
+from hccinfhir.model_calculate import calculate_raf
+
+diagnosis_codes = ['E119', 'I509']  # Diabetes without complications, Heart failure
+result = calculate_raf(
+   diagnosis_codes=diagnosis_codes,
+   model_name="CMS-HCC Model V24",
+   age=67,
+   sex='F'
+)
+```
 
-hcc_processor = HCCInFHIR()
-sld_list = hcc_processor.extract_sld_list(eob_list)
-filtered_sld = hcc_processor.apply_filters(sld_list)  # future
-raf_details = hcc_processor.calculate_raf(filtered_sld, demographic_data)  # future
+### 4. HCCInFHIR Class
+The main processor class that integrates extraction, filtering, and calculation components:
+
+```python
+from hccinfhir.hccinfhir import HCCInFHIR
+from hccinfhir.datamodels import Demographics
+
+# Initialize with custom configuration
+hcc_processor = HCCInFHIR(
+    filter_claims=True,                                    # Enable claim filtering
+    model_name="CMS-HCC Model V28",                       # Choose HCC model version
+    proc_filtering_filename="ra_eligible_cpt_hcpcs_2025.csv",  # CPT/HCPCS filtering rules
+    dx_cc_mapping_filename="ra_dx_to_cc_2025.csv"         # Diagnosis to CC mapping
+)
+
+# Define beneficiary demographics
+demographics = Demographics(
+    age=67,
+    sex='F',
+    dual_elgbl_cd='00',    # Not dual eligible
+    orec='0',              # Old age
+    crec='0',              # Current old age
+    new_enrollee=False,
+    snp=False
+)
+
+# Method 1: Process FHIR EOB resources
+raf_result = hcc_processor.run(eob_list, demographics)
+
+# Method 2: Process service level data
+service_data = [{
+    "procedure_code": "99214",
+    "claim_diagnosis_codes": ["E11.9", "I10"],
+    "claim_type": "71",
+    "service_date": "2024-01-15"
+}]
+raf_result = hcc_processor.run_from_service_data(service_data, demographics)
+
+# Method 3: Direct diagnosis processing
+diagnosis_codes = ['E119', 'I509']
+raf_result = hcc_processor.calculate_from_diagnosis(diagnosis_codes, demographics)
+
+# RAF Result contains:
+print(f"Risk Score: {raf_result['risk_score']}")
+print(f"HCC List: {raf_result['hcc_list']}")
+print(f"CC to Diagnosis Mapping: {raf_result['cc_to_dx']}")
+print(f"Applied Coefficients: {raf_result['coefficients']}")
+print(f"Applied Interactions: {raf_result['interactions']}")
 ```
 
+The HCCInFHIR class provides three main processing methods:
+
+1. `run(eob_list, demographics)`: Process FHIR ExplanationOfBenefit resources
+   - Extracts service data from FHIR resources
+   - Applies filtering rules if enabled
+   - Calculates RAF scores using the specified model
+
+2. `run_from_service_data(service_data, demographics)`: Process standardized service data
+   - Accepts pre-formatted service level data
+   - Validates data structure using Pydantic models
+   - Applies filtering and calculates RAF scores
+
+3. `calculate_from_diagnosis(diagnosis_codes, demographics)`: Direct diagnosis processing
+   - Processes raw diagnosis codes without service context
+   - Useful for quick RAF calculations or validation
+   - Bypasses service-level filtering
+
+Each method returns a RAFResult containing:
+- Final risk score
+- List of HCCs
+- Mapping of condition categories to diagnosis codes
+- Applied coefficients and interactions
+- Processed service level data (when applicable)
+
 ## Testing
 ```bash
 $ python3 -m hatch shell
@@ -172,8 +270,48 @@ $ python3 -m pytest tests/*
 3. Add support for allowed_amount in 837 if available in different segments
 4. Consider adding more robust error handling in both implementations
 
+## Data Files
+
+`ra_dx_to_cc_mapping_2025.csv`
+```sql
+SELECT diagnosis_code, cc, model_name 
+FROM ra_dx_to_cc_mapping 
+WHERE year = 2025 and model_type = 'Initial';
+```
+
+`ra_hierarchies_2025.csv`
+```sql
+SELECT cc_parent, 
+  cc_child, 
+  model_domain, 
+  model_version, 
+  model_fullname
+FROM ra_hierarchies
+WHERE eff_last_date > '2025-01-01';
+```
+
+`ra_coefficients_2025.csv`
+```sql
+SELECT coefficient, value, model_domain, model_version 
+FROM ra_coefficients 
+WHERE eff_last_date > '2025-01-01';
+```   
+
+`ra_eligible_cpt_hcpcs_2025.csv`
+```sql
+SELECT DISTINCT cpt_hcpcs_code
+FROM mimi_ws_1.cmspayment.ra_eligible_cpt_hcpcs
+WHERE is_included = 'yes' AND YEAR(mimi_src_file_date) = 2024;
+```
+
 ## Contributing
 Join us at [mimilabs](https://mimilabs.ai/signup). Reference data available in MIMILabs data lakehouse.
 
+## Publishing (only for those maintainers...)
+```bash
+$ hatch build
+$ hatch publish
+```
+
 ## License
 Apache License 2.0