hccinfhir 0.2.5__py3-none-any.whl → 0.2.7__py3-none-any.whl

hccinfhir/model_calculate.py

@@ -115,6 +115,8 @@ def calculate_raf(diagnosis_codes: List[str],
             demographic_interactions[key] = value
         elif key.startswith('OriginallyDisabled_'):
             demographic_interactions[key] = value
+        elif key == 'LTIMCAID':
+            demographic_interactions[key] = value
 
     coefficients_demographics = apply_coefficients(demographics,
                                                    set(),

hccinfhir/model_coefficients.py

@@ -101,7 +101,11 @@ def apply_coefficients(demographics: Demographics,
 
     # Apply the coefficients
     for hcc in hcc_set:
-        key = (f"{prefix}HCC{hcc}".lower(), model_name)
+        # For RxHCC models, use RXHCC prefix instead of HCC
+        if 'RxHCC' in model_name:
+            key = (f"{prefix}RXHCC{hcc}".lower(), model_name)
+        else:
+            key = (f"{prefix}HCC{hcc}".lower(), model_name)
 
         if key in coefficients:
             value = coefficients[key]
@@ -112,11 +116,23 @@ def apply_coefficients(demographics: Demographics,
         if interaction_value < 1:
             continue
 
+        # Standard prefix-based lookup
         key = (f"{prefix}{interaction_key}".lower(), model_name)
         if key in coefficients:
             value = coefficients[key]
             output[interaction_key] = value
 
+        # No-prefix lookup for ESRD duration coefficients stored without prefix
+        # ESRD V21: GE65_DUR*, LT65_DUR*; ESRD V24: FGC_*, FGI_*, LTI_GE65/LT65
+        if (interaction_key.startswith('FGC') or
+            interaction_key.startswith('FGI') or
+            interaction_key.startswith('GE65_DUR') or
+            interaction_key.startswith('LT65_DUR') or
+            interaction_key in ('LTI_GE65', 'LTI_LT65')):
+            key = (interaction_key.lower(), model_name)
+            if key in coefficients:
+                value = coefficients[key]
+                output[interaction_key] = value
 
     return output
 

hccinfhir/model_interactions.py

@@ -6,50 +6,145 @@ def has_any_hcc(hcc_list: List[str], hcc_set: Set[str]) -> int:
     return int(bool(set(hcc_list) & hcc_set))
 
 def create_demographic_interactions(demographics: Demographics) -> dict:
-    """Creates common demographic-based interactions"""
+    """Creates common demographic-based interactions.
+
+    This function creates interaction variables that are model-agnostic.
+    The coefficient lookup will match only the relevant coefficients for
+    each model. Comments indicate which models primarily use each interaction.
+    """
     interactions = {}
-    # Determine sex from demographics.sex instead of category
-    # Category can start with 'NEM'/'NEF' for new enrollees, not just 'M'/'F'
+
+    # Common demographic flags
     is_female = demographics.sex in ('F', '2')
     is_male = demographics.sex in ('M', '1')
     is_aged = not demographics.non_aged
-    
-    # Original Disability interactions
+    lti = int(demographics.lti) if demographics.lti else 0
+    fbd = demographics.fbd
+    pbd = demographics.pbd
+    graft_months = demographics.graft_months
+
+    # Medicaid indicator (any dual status)
+    mcaid = 1 if demographics.dual_elgbl_cd in {
+        '01', '02', '03', '04', '05', '06', '07', '08', '09', '10'
+    } else 0
+
+    # Original Disability interactions (V22, V24, V28, ESRD V21, V24)
+    # Only for aged (65+); looked up with prefix (e.g., CNA_, DI_)
     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:
+    # Originally ESRD interactions (ESRD V21, V24 Dialysis); looked up as DI_Originally_ESRD_*
+    if is_aged and demographics.orec in ('2', '3'):
+        interactions['Originally_ESRD_Female'] = int(is_female)
+        interactions['Originally_ESRD_Male'] = int(is_male)
+
+    # MCAID × sex × age interactions (ESRD V21 Dialysis and Community Graft only)
+    # V21 used MCAID; V24 uses FBDual/PBDual (handled in create_dual_interactions)
+    if mcaid:
+        interactions['MCAID_Female_Aged'] = int(is_female) * int(is_aged)
+        interactions['MCAID_Female_NonAged'] = int(is_female) * int(not is_aged)
+        interactions['MCAID_Male_Aged'] = int(is_male) * int(is_aged)
+        interactions['MCAID_Male_NonAged'] = int(is_male) * int(not is_aged)
+
+    # LTI interactions for ESRD models
+    if lti:
+        # ESRD V24 Dialysis: looked up as DI_LTI_Aged, DI_LTI_NonAged
         interactions['LTI_Aged'] = int(is_aged)
         interactions['LTI_NonAged'] = int(not is_aged)
-    else:
-        interactions['LTI_Aged'] = 0
-        interactions['LTI_NonAged'] = 0
-        
+        # ESRD V24 Graft Institutional: looked up WITHOUT prefix as LTI_GE65, LTI_LT65
+        interactions['LTI_GE65'] = int(is_aged)
+        interactions['LTI_LT65'] = int(not is_aged)
+
+    # LTIMCAID for V24, V28 Institutional model; looked up as INS_LTIMCAID
+    if lti and mcaid:
+        interactions['LTIMCAID'] = lti * mcaid
+
+    # New Enrollee interactions for V24, V28, ESRD V21, ESRD V24
     nemcaid = False
-    if demographics.new_enrollee and demographics.dual_elgbl_cd in {'01', '02', '03', '04', '05', '06', '08'}:
+    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"))
-    
-    fbd = demographics.fbd
+    ne_origds = int(
+        demographics.age >= 65 and
+        demographics.orec is not None and
+        demographics.orec == "1"
+    )
 
-    # Four mutually exclusive groups
+    # V24, V28, ESRD V21: MCAID/NMCAID style; looked up with NE_ or SNPNE_ prefix
     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),
+    })
+
+    # ESRD V24: FBD/ND_PBD style; looked up with DNE_ or GNE_ prefix
+    interactions.update({
         f'FBD_NORIGDIS_{demographics.category}': int(fbd and not ne_origds),
         f'FBD_ORIGDIS_{demographics.category}': int(fbd and ne_origds),
         f'ND_PBD_NORIGDIS_{demographics.category}': int(not fbd and not ne_origds),
         f'ND_PBD_ORIGDIS_{demographics.category}': int(not fbd and ne_origds)
     })
 
-    # output only non-zero interactions
+    # Functioning Graft Duration "transplant bumps" for ESRD models
+    # All looked up WITHOUT prefix - they match directly by name
+    if graft_months and graft_months >= 4:
+        is_dur4_9 = (4 <= graft_months <= 9)
+        is_dur10pl = (graft_months >= 10)
+
+        # ESRD V21: simple age-based bumps (GE65_DUR4_9, LT65_DUR4_9, etc.)
+        if is_dur4_9:
+            interactions['GE65_DUR4_9'] = int(is_aged)
+            interactions['LT65_DUR4_9'] = int(not is_aged)
+        if is_dur10pl:
+            interactions['GE65_DUR10PL'] = int(is_aged)
+            interactions['LT65_DUR10PL'] = int(not is_aged)
+
+        # ESRD V24: FGC (Community) / FGI (Institutional) stratified by dual status
+        if not fbd:
+            # Non-Dual and Partial Benefit Dual (ND_PBD)
+            if is_dur4_9:
+                interactions.update({
+                    'FGC_GE65_DUR4_9_ND_PBD': int(is_aged) * int(not lti),
+                    'FGC_LT65_DUR4_9_ND_PBD': int(not is_aged) * int(not lti),
+                    'FGI_GE65_DUR4_9_ND_PBD': int(is_aged) * lti,
+                    'FGI_LT65_DUR4_9_ND_PBD': int(not is_aged) * lti,
+                })
+            if is_dur10pl:
+                interactions.update({
+                    'FGC_GE65_DUR10PL_ND_PBD': int(is_aged) * int(not lti),
+                    'FGC_LT65_DUR10PL_ND_PBD': int(not is_aged) * int(not lti),
+                    'FGI_GE65_DUR10PL_ND_PBD': int(is_aged) * lti,
+                    'FGI_LT65_DUR10PL_ND_PBD': int(not is_aged) * lti,
+                })
+            # Extra PBD flag for Partial Benefit Dual members
+            if pbd:
+                interactions.update({
+                    'FGC_PBD_GE65_flag': int(is_aged) * int(not lti),
+                    'FGC_PBD_LT65_flag': int(not is_aged) * int(not lti),
+                    'FGI_PBD_GE65_flag': int(is_aged) * lti,
+                    'FGI_PBD_LT65_flag': int(not is_aged) * lti,
+                })
+        else:
+            # Full Benefit Dual (FBD)
+            if is_dur4_9:
+                interactions.update({
+                    'FGC_GE65_DUR4_9_FBD': int(is_aged) * int(not lti),
+                    'FGC_LT65_DUR4_9_FBD': int(not is_aged) * int(not lti),
+                    'FGI_GE65_DUR4_9_FBD': int(is_aged) * lti,
+                    'FGI_LT65_DUR4_9_FBD': int(not is_aged) * lti,
+                })
+            if is_dur10pl:
+                interactions.update({
+                    'FGC_GE65_DUR10PL_FBD': int(is_aged) * int(not lti),
+                    'FGC_LT65_DUR10PL_FBD': int(not is_aged) * int(not lti),
+                    'FGI_GE65_DUR10PL_FBD': int(is_aged) * lti,
+                    'FGI_LT65_DUR10PL_FBD': int(not is_aged) * lti,
+                })
+
+    # Output only non-zero interactions
     interactions = {k: v for k, v in interactions.items() if v > 0}
 
     return interactions
@@ -214,7 +309,7 @@ def create_disease_interactions(model_name: ModelName,
             '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'],
+            'gSubstanceUseDisorder_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'],

{hccinfhir-0.2.5.dist-info → hccinfhir-0.2.7.dist-info}/METADATA

@@ -1,6 +1,6 @@
 Metadata-Version: 2.3
 Name: hccinfhir
-Version: 0.2.5
+Version: 0.2.7
 Summary: HCC Algorithm for FHIR Resources
 Project-URL: Homepage, https://github.com/mimilabs/hccinfhir
 Project-URL: Issues, https://github.com/mimilabs/hccinfhir/issues

{hccinfhir-0.2.5.dist-info → hccinfhir-0.2.7.dist-info}/RECORD

@@ -8,12 +8,12 @@ hccinfhir/extractor_837.py,sha256=fGsvBTWIj9dsHLGGR67AdlYDSsFi5qnSVlTgwkL1f-E,15
 hccinfhir/extractor_fhir.py,sha256=wUN3vTm1oTZ-KvfcDebnpQMxAC-7YlRKv12Wrv3p85A,8490
 hccinfhir/filter.py,sha256=j_yD2g6RBXVUV9trKkWzsQ35x3fRvfKUPvEXKUefI64,2007
 hccinfhir/hccinfhir.py,sha256=NydnH3WBvuyskn76hY70LpUS6XuIEoax_kip1mgfpHw,11225
-hccinfhir/model_calculate.py,sha256=_TUWNVUsBym0pre3wltXvRuipQaONQ0QBfWPFNAeDsQ,8347
-hccinfhir/model_coefficients.py,sha256=5n3QzHX6FJ3MlO0cV9NS7Bqt-lxzVvT_M3zFaWq6Gng,4685
+hccinfhir/model_calculate.py,sha256=32JOFItbEQ5OAGPrvfLnQSgW2aBiZ-JCS7ixEB6TAZY,8429
+hccinfhir/model_coefficients.py,sha256=PGZDAFRyz7asT0epl4xTatNCsuzYaISdbXEHU2wQ27U,5504
 hccinfhir/model_demographics.py,sha256=nImKtJCq1HkR9w2GU8aikybJFgow71CPufBRV8Jn7fM,8932
 hccinfhir/model_dx_to_cc.py,sha256=Yjc6xKI-jMXsbOzS_chc4NI15Bwagb7BwZZ8cKQaTbk,1540
 hccinfhir/model_hierarchies.py,sha256=cboUnSHZZfOxA8QZKV4QIE-32duElssML32OqYT-65g,1542
-hccinfhir/model_interactions.py,sha256=g6jK27Xu8RQUHS3lk4sk2v6w6wqd52mdbGn0BsnR7Pk,21394
+hccinfhir/model_interactions.py,sha256=prguJoOWBIO97UEpD0njXPvYM6-hoNjBIFYxDOxkLt0,25816
 hccinfhir/samples.py,sha256=2VSWS81cv9EnaHqK7sd6CjwG6FUI9E--5wHgD000REI,9952
 hccinfhir/utils.py,sha256=WQ2atW0CrdX7sAz_YRLeY4JD-CuH0o-WRusQ_xVVfgY,12152
 hccinfhir/data/__init__.py,sha256=SGiSkpGrnxbvtEFMMlk82NFHOE50hFXcgKwKUSuVZUg,45
@@ -29,8 +29,8 @@ hccinfhir/data/ra_eligible_cpt_hcpcs_2024.csv,sha256=CawKImfCb8fFMDbWwqvNLRyRAda
 hccinfhir/data/ra_eligible_cpt_hcpcs_2025.csv,sha256=-tMvv2su5tsSbGUh6fZZCMUEkXInBpcTtbUCi2o_UwI,40359
 hccinfhir/data/ra_eligible_cpt_hcpcs_2026.csv,sha256=EYGN7k_rgCpJe59lL_yNInUcCkdETDWGSFTXII3LZ0Y,40497
 hccinfhir/data/ra_hierarchies_2025.csv,sha256=HQSPNloe6mvvwMgv8ZwYAfWKkT2b2eUvm4JQy6S_mVQ,13045
-hccinfhir/data/ra_hierarchies_2026.csv,sha256=A6ZQZb0rpRWrySBB_KA5S4PGtMxWuzB2guU3aBE09v0,19596
-hccinfhir/data/ra_labels_2026.csv,sha256=YstfP7s-3ZwjP4I_GYPPj3_yn-PQK3Q0Q_MVYZhsfjY,50248
+hccinfhir/data/ra_hierarchies_2026.csv,sha256=pKevSx-dYfLyO-Leruh2AFLn5uO4y49O9EOr-O6-cbY,19595
+hccinfhir/data/ra_labels_2026.csv,sha256=P-Ym0np06E_CxwELdBGZZ7j5NwhXLsHoRPnp3jeYWn4,50248
 hccinfhir/sample_files/__init__.py,sha256=SGiSkpGrnxbvtEFMMlk82NFHOE50hFXcgKwKUSuVZUg,45
 hccinfhir/sample_files/sample_834_01.txt,sha256=J2HMXfY6fAFpV36rvLQ3QymRRS2TPqf3TQY6CNS7TrE,1627
 hccinfhir/sample_files/sample_834_02.txt,sha256=vSvjM69kKfOW9e-8dvlO9zDcRPpOD7LmekLu68z4aB4,926
@@ -55,7 +55,7 @@ hccinfhir/sample_files/sample_eob_1.json,sha256=_NGSVR2ysFpx-DcTvyga6dFCzhQ8Vi9f
 hccinfhir/sample_files/sample_eob_2.json,sha256=FcnJcx0ApOczxjJ_uxVLzCep9THfNf4xs9Yf7hxk8e4,1769
 hccinfhir/sample_files/sample_eob_200.ndjson,sha256=CxpjeQ1DCMUzZILaM68UEhfxO0p45YGhDDoCZeq8PxU,1917986
 hccinfhir/sample_files/sample_eob_3.json,sha256=4BW4wOMBEEU9RDfJR15rBEvk0KNHyuMEh3e055y87Hc,2306
-hccinfhir-0.2.5.dist-info/METADATA,sha256=fjqK-VAKUQ_zblUqz4p8qddjSZje16tYVnPGEYyzw4Q,37381
-hccinfhir-0.2.5.dist-info/WHEEL,sha256=C2FUgwZgiLbznR-k0b_5k3Ai_1aASOXDss3lzCUsUug,87
-hccinfhir-0.2.5.dist-info/licenses/LICENSE,sha256=xx0jnfkXJvxRnG63LTGOxlggYnIysveWIZ6H3PNdCrQ,11357
-hccinfhir-0.2.5.dist-info/RECORD,,
+hccinfhir-0.2.7.dist-info/METADATA,sha256=d52fnw3hxrWH7BLxEtkB-aefn4K6bo0g6JjLivHTBFM,37381
+hccinfhir-0.2.7.dist-info/WHEEL,sha256=C2FUgwZgiLbznR-k0b_5k3Ai_1aASOXDss3lzCUsUug,87
+hccinfhir-0.2.7.dist-info/licenses/LICENSE,sha256=xx0jnfkXJvxRnG63LTGOxlggYnIysveWIZ6H3PNdCrQ,11357
+hccinfhir-0.2.7.dist-info/RECORD,,