hccinfhir 0.1.4__tar.gz → 0.1.5__tar.gz

{hccinfhir-0.1.4 → hccinfhir-0.1.5}/PKG-INFO

@@ -1,6 +1,6 @@
 Metadata-Version: 2.3
 Name: hccinfhir
-Version: 0.1.4
+Version: 0.1.5
 Summary: HCC Algorithm for FHIR Resources
 Project-URL: Homepage, https://github.com/mimilabs/hccinfhir
 Project-URL: Issues, https://github.com/mimilabs/hccinfhir/issues
@@ -60,12 +60,12 @@ print(f"HCCs: {result.hcc_list}")
 HCCInFHIR supports three primary data sources for HCC risk adjustment calculations:
 
 ### 1. **CMS Encounter Data Records (EDRs)**
-- **Input**: X12 837 envelope files (text format) + demographic data from payers
+- **Input**: X12 837 5010 transaction files (text format) + demographic data from payers
 - **Use Case**: Medicare Advantage plans processing encounter data for CMS submissions
 - **Output**: Risk scores with detailed HCC mappings and interactions
 
 ### 2. **Clearinghouse 837 Claims**
-- **Input**: X12 837 institutional/professional claim files + patient demographics
+- **Input**: X12 837 5010 institutional/professional claim files + patient demographics
 - **Use Case**: Health plans and providers calculating risk scores from claims data
 - **Output**: Service-level analysis with filtering and risk score calculations
 
@@ -579,17 +579,99 @@ except ModelNotFoundError as e:
     print(f"Model configuration error: {e}")
 ```
 
-## 🧪 Testing
+### Custom Valuesets
+
+Users can generate custom and more specific valuesets using the mimilabs data lakehouse.
+
+For example, the valuesets in the package are created as follows:
+
+`ra_dx_to_cc_mapping_2026.csv`
+```sql
+WITH latest_years AS (
+  SELECT 
+    model_name,
+    MAX(year) as latest_year
+  FROM mimi_ws_1.cmspayment.ra_dx_to_cc_mapping 
+  WHERE model_type = 'Initial'
+    AND year <= 2026  -- Don't go beyond 2026
+  GROUP BY model_name
+)
+SELECT 
+  r.diagnosis_code, 
+  r.cc, 
+  r.model_name
+FROM mimi_ws_1.cmspayment.ra_dx_to_cc_mapping r
+INNER JOIN latest_years l 
+  ON r.model_name = l.model_name 
+  AND r.year = l.latest_year
+WHERE r.model_type = 'Initial'
+ORDER BY r.model_name, r.diagnosis_code;
+```
+
+`ra_hierarchies_2026.csv`
+```sql
+WITH latest_dates AS (
+  SELECT 
+    model_domain,
+    model_version,
+    model_fullname,
+    MAX(eff_last_date) as latest_eff_last_date
+  FROM mimi_ws_1.cmspayment.ra_hierarchies 
+  GROUP BY model_domain, model_version, model_fullname
+)
+SELECT 
+  r.cc_parent, 
+  r.cc_child, 
+  r.model_domain, 
+  r.model_version, 
+  r.model_fullname
+FROM mimi_ws_1.cmspayment.ra_hierarchies r
+INNER JOIN latest_dates l 
+  ON r.model_domain = l.model_domain 
+  AND r.model_version = l.model_version
+  AND r.model_fullname = l.model_fullname
+  AND r.eff_last_date = l.latest_eff_last_date
+ORDER BY r.model_domain, r.model_version, r.model_fullname, r.cc_parent, r.cc_child;
+```
+
+
+`ra_coefficients_2026.csv`
+```sql
+WITH preferred_records AS (
+  SELECT 
+    model_domain,
+    model_version,
+    MAX(eff_last_date) as latest_eff_last_date
+  FROM mimi_ws_1.cmspayment.ra_coefficients
+  GROUP BY model_domain, model_version
+)
+SELECT 
+  r.coefficient,
+  r.value, 
+  r.model_domain, 
+  r.model_version
+FROM mimi_ws_1.cmspayment.ra_coefficients r
+INNER JOIN preferred_records p
+  ON r.model_domain = p.model_domain 
+  AND r.model_version = p.model_version
+  AND r.eff_last_date = p.latest_eff_last_date
+ORDER BY r.model_domain, r.model_version, r.coefficient;
+```   
+
+`ra_eligible_cpt_hcpcs_2026.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) = 2025;
+```
 
-```bash
-# Install development dependencies
-pip install -e ".[dev]"
 
-# Run tests
-pytest tests/
+## 🧪 Testing
 
-# Run with coverage
-pytest --cov=hccinfhir tests/
+```bash
+$ hatch shell
+$ pip install -e .
+$ pytest tests/*
 ```
 
 ## 📄 License

{hccinfhir-0.1.4 → hccinfhir-0.1.5}/README.md

@@ -46,12 +46,12 @@ print(f"HCCs: {result.hcc_list}")
 HCCInFHIR supports three primary data sources for HCC risk adjustment calculations:
 
 ### 1. **CMS Encounter Data Records (EDRs)**
-- **Input**: X12 837 envelope files (text format) + demographic data from payers
+- **Input**: X12 837 5010 transaction files (text format) + demographic data from payers
 - **Use Case**: Medicare Advantage plans processing encounter data for CMS submissions
 - **Output**: Risk scores with detailed HCC mappings and interactions
 
 ### 2. **Clearinghouse 837 Claims**
-- **Input**: X12 837 institutional/professional claim files + patient demographics
+- **Input**: X12 837 5010 institutional/professional claim files + patient demographics
 - **Use Case**: Health plans and providers calculating risk scores from claims data
 - **Output**: Service-level analysis with filtering and risk score calculations
 
@@ -565,17 +565,99 @@ except ModelNotFoundError as e:
     print(f"Model configuration error: {e}")
 ```
 
-## 🧪 Testing
+### Custom Valuesets
+
+Users can generate custom and more specific valuesets using the mimilabs data lakehouse.
+
+For example, the valuesets in the package are created as follows:
+
+`ra_dx_to_cc_mapping_2026.csv`
+```sql
+WITH latest_years AS (
+  SELECT 
+    model_name,
+    MAX(year) as latest_year
+  FROM mimi_ws_1.cmspayment.ra_dx_to_cc_mapping 
+  WHERE model_type = 'Initial'
+    AND year <= 2026  -- Don't go beyond 2026
+  GROUP BY model_name
+)
+SELECT 
+  r.diagnosis_code, 
+  r.cc, 
+  r.model_name
+FROM mimi_ws_1.cmspayment.ra_dx_to_cc_mapping r
+INNER JOIN latest_years l 
+  ON r.model_name = l.model_name 
+  AND r.year = l.latest_year
+WHERE r.model_type = 'Initial'
+ORDER BY r.model_name, r.diagnosis_code;
+```
+
+`ra_hierarchies_2026.csv`
+```sql
+WITH latest_dates AS (
+  SELECT 
+    model_domain,
+    model_version,
+    model_fullname,
+    MAX(eff_last_date) as latest_eff_last_date
+  FROM mimi_ws_1.cmspayment.ra_hierarchies 
+  GROUP BY model_domain, model_version, model_fullname
+)
+SELECT 
+  r.cc_parent, 
+  r.cc_child, 
+  r.model_domain, 
+  r.model_version, 
+  r.model_fullname
+FROM mimi_ws_1.cmspayment.ra_hierarchies r
+INNER JOIN latest_dates l 
+  ON r.model_domain = l.model_domain 
+  AND r.model_version = l.model_version
+  AND r.model_fullname = l.model_fullname
+  AND r.eff_last_date = l.latest_eff_last_date
+ORDER BY r.model_domain, r.model_version, r.model_fullname, r.cc_parent, r.cc_child;
+```
+
+
+`ra_coefficients_2026.csv`
+```sql
+WITH preferred_records AS (
+  SELECT 
+    model_domain,
+    model_version,
+    MAX(eff_last_date) as latest_eff_last_date
+  FROM mimi_ws_1.cmspayment.ra_coefficients
+  GROUP BY model_domain, model_version
+)
+SELECT 
+  r.coefficient,
+  r.value, 
+  r.model_domain, 
+  r.model_version
+FROM mimi_ws_1.cmspayment.ra_coefficients r
+INNER JOIN preferred_records p
+  ON r.model_domain = p.model_domain 
+  AND r.model_version = p.model_version
+  AND r.eff_last_date = p.latest_eff_last_date
+ORDER BY r.model_domain, r.model_version, r.coefficient;
+```   
+
+`ra_eligible_cpt_hcpcs_2026.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) = 2025;
+```
 
-```bash
-# Install development dependencies
-pip install -e ".[dev]"
 
-# Run tests
-pytest tests/
+## 🧪 Testing
 
-# Run with coverage
-pytest --cov=hccinfhir tests/
+```bash
+$ hatch shell
+$ pip install -e .
+$ pytest tests/*
 ```
 
 ## 📄 License

{hccinfhir-0.1.4 → hccinfhir-0.1.5}/hccinfhir/__init__.py

@@ -21,7 +21,7 @@ from .samples import (
     list_available_samples
 )
 
-__version__ = "0.1.2"
+__version__ = "0.1.5"
 __author__ = "Yubin Park"
 __email__ = "yubin.park@mimilabs.ai"
 

{hccinfhir-0.1.4 → hccinfhir-0.1.5}/hccinfhir/model_calculate.py

@@ -83,9 +83,11 @@ def calculate_raf(diagnosis_codes: List[str],
     coefficients = apply_coefficients(demographics, hcc_set, interactions, model_name)
 
     hcc_chronic = set()
+    interactions_chronic = {}
     for hcc in hcc_set:
         if is_chronic_mapping.get((hcc, model_name), False):
             hcc_chronic.add(hcc)
+        interactions_chronic = apply_interactions(demographics, hcc_chronic, model_name)
 
     demographic_interactions = {}
     for key, value in interactions.items():
@@ -104,11 +106,13 @@ def calculate_raf(diagnosis_codes: List[str],
                                                    model_name)
     coefficients_chronic_only = apply_coefficients(demographics, 
                                                    hcc_chronic, 
-                                                   demographic_interactions, 
+                                                   interactions_chronic, 
                                                    model_name)
     
     # Calculate risk scores
+    print(f"Coefficients: {coefficients}")
     risk_score = sum(coefficients.values())
+    print(f"Risk Score: {risk_score}")
     risk_score_demographics = sum(coefficients_demographics.values())
     risk_score_chronic_only = sum(coefficients_chronic_only.values()) - risk_score_demographics
     risk_score_hcc = risk_score - risk_score_demographics

{hccinfhir-0.1.4 → hccinfhir-0.1.5}/pyproject.toml

@@ -4,7 +4,7 @@ build-backend = "hatchling.build"
 
 [project]
 name = "hccinfhir"
-version = "0.1.4"
+version = "0.1.5"
 authors = [
   { name="Yubin Park", email="yubin.park@mimilabs.ai" },
 ]