BFD-4474: add clm rndrg prvdr tax num Changes to add IncludeTaxHeader and use boolean to display the header accordingly in the FHIR output for clm_rndrg_prvdr_tax_num (#3161)

Author: patrickgmayday

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/ClaimFilterOptions.java

@@ -0,0 +1,14 @@
+package gov.cms.bfd.server.ng;
+
+import lombok.Builder;
+import lombok.Value;
+
+/** Claim Filter options. */
+@Value
+@Builder
+public class ClaimFilterOptions {
+
+  @Builder.Default SamhsaFilterMode samhsaFilterMode = SamhsaFilterMode.EXCLUDE;
+
+  @Builder.Default boolean includeTaxNumber = false;
+}

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimBase.java

@@ -1,6 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
-import gov.cms.bfd.server.ng.ClaimSecurityStatus;
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.beneficiary.model.BeneficiarySimple;
 import gov.cms.bfd.server.ng.converter.DefaultFalseBooleanConverter;
 import gov.cms.bfd.server.ng.util.DateUtil;
@@ -64,10 +64,11 @@ public abstract class ClaimBase {
   /**
    * Convert the claim info to a FHIR ExplanationOfBenefit.
    *
-   * @param securityStatus securityStatus
+   * @param options claim filter options
+   * @param claimState computed claim state
    * @return ExplanationOfBenefit
    */
-  public ExplanationOfBenefit toFhir(ClaimSecurityStatus securityStatus) {
+  public ExplanationOfBenefit toFhir(ClaimFilterOptions options, ClaimState claimState) {
     var eob = new ExplanationOfBenefit();
     eob.setId(String.valueOf(claimUniqueId));
     eob.setPatient(PatientReferenceFactory.toFhir(beneficiary.getXrefSk()));
@@ -77,7 +78,8 @@ public ExplanationOfBenefit toFhir(ClaimSecurityStatus securityStatus) {
     claimTypeCode.toFhirSubtype().ifPresent(eob::setSubType);
     claimTypeCode.toFhirAdjudication().ifPresent(eob::addAdjudication);
 
-    eob.setMeta(meta.toFhir(claimTypeCode, securityStatus, finalAction, getMetaSourceSk()));
+    eob.setMeta(
+        meta.toFhir(claimTypeCode, claimState.getSecurityStatus(), finalAction, getMetaSourceSk()));
     identifiers.toFhir(claimTypeCode).forEach(eob::addIdentifier);
     identifiers.toFhirRelatedClaim(claimTypeCode).ifPresent(eob::addRelated);
     eob.setBillablePeriod(billablePeriod.toFhir());

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimInstitutionalBase.java

@@ -2,7 +2,7 @@
 
 import static gov.cms.bfd.server.ng.claim.model.ClaimDiagnosisType.*;
 
-import gov.cms.bfd.server.ng.ClaimSecurityStatus;
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.util.SequenceGenerator;
 import jakarta.persistence.Column;
 import jakarta.persistence.Embedded;
@@ -17,6 +17,7 @@
 /** Shared base for institutional claim types (NCH and Shared Systems variants). */
 @MappedSuperclass
 @Getter
+@SuppressWarnings("java:S6539")
 public abstract class ClaimInstitutionalBase extends ClaimBase {
 
   @Column(name = "clm_cntrctr_num")
@@ -83,10 +84,10 @@ public abstract class ClaimInstitutionalBase extends ClaimBase {
   protected void applyOutcomeOverride(ExplanationOfBenefit eob) {}
 
   @Override
-  public ExplanationOfBenefit toFhir(ClaimSecurityStatus securityStatus) {
-    var eob = super.toFhir(securityStatus);
+  public ExplanationOfBenefit toFhir(ClaimFilterOptions options, ClaimState claimState) {
+    var eob = super.toFhir(options, claimState);
 
-    addClaimItems(eob);
+    addClaimItems(eob, options);
     addDiagnoses(eob);
     addProviders(eob);
     applyOutcomeOverride(eob);
@@ -113,11 +114,12 @@ private void addInsurance(ExplanationOfBenefit eob) {
         .toList();
   }
 
-  private void addClaimItems(ExplanationOfBenefit eob) {
+  private void addClaimItems(ExplanationOfBenefit eob, ClaimFilterOptions options) {
+
     getItems()
         .forEach(
             item -> {
-              var claimLine = item.getClaimLine().toFhirItemComponent();
+              var claimLine = item.getClaimLine().toFhirItemComponent(options);
               var claimContext = getClaimTypeCode().toContext();
 
               claimLine.ifPresent(eob::addItem);

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimLineBase.java

@@ -1,5 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import java.util.List;
 import java.util.Optional;
 import org.hl7.fhir.r4.model.ExplanationOfBenefit;
@@ -9,7 +10,7 @@ interface ClaimLineBase {
 
   Optional<Observation> toFhirObservation(int bfdRowId);
 
-  Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent();
+  Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent(ClaimFilterOptions options);
 
   List<ExplanationOfBenefit.SupportingInformationComponent> toFhirSupportingInfo(
       SupportingInfoFactory supportingInfoFactory);

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimLineInstitutionalBase.java

@@ -1,5 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.converter.NonZeroIntConverter;
 import gov.cms.bfd.server.ng.util.DateUtil;
 import gov.cms.bfd.server.ng.util.FhirUtil;
@@ -79,7 +80,8 @@ public Optional<Observation> toFhirObservation(int bfdRowId) {
   }
 
   @Override
-  public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent() {
+  public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent(
+      ClaimFilterOptions options) {
     if (claimLineNumber.isEmpty()) {
       return Optional.empty();
     }

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimLineProfessionalBase.java

@@ -1,5 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.converter.NonZeroIntConverter;
 import gov.cms.bfd.server.ng.util.DateUtil;
 import jakarta.persistence.AttributeOverride;
@@ -69,7 +70,8 @@ abstract class ClaimLineProfessionalBase implements ClaimLineBase {
   @Embedded private ClaimLineProfessionalExtensions extensions;
 
   @Override
-  public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent() {
+  public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent(
+      ClaimFilterOptions options) {
     if (claimLineNumber.isEmpty()) {
       return Optional.empty();
     }
@@ -89,7 +91,7 @@ public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent() {
 
     getAdjudicationCharge().toFhir().forEach(line::addAdjudication);
     placeOfServiceCode.map(c -> line.setLocation(c.toFhir()));
-    getFhirExtensions().forEach(line::addExtension);
+    getFhirExtensions(options).forEach(line::addExtension);
 
     return Optional.of(line);
   }
@@ -122,7 +124,7 @@ public List<ExplanationOfBenefit.SupportingInformationComponent> toFhirSupportin
 
   abstract void populateProductAndQuantity(ExplanationOfBenefit.ItemComponent item);
 
-  protected List<Extension> getFhirExtensions() {
-    return getExtensions().toFhir();
+  protected List<Extension> getFhirExtensions(ClaimFilterOptions options) {
+    return getExtensions().toFhir(options);
   }
 }

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimLineProfessionalExtensions.java

@@ -1,7 +1,9 @@
 package gov.cms.bfd.server.ng.claim.model;
 
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import jakarta.persistence.Column;
 import jakarta.persistence.Embeddable;
+import jakarta.persistence.Embedded;
 import java.util.List;
 import java.util.Optional;
 import java.util.stream.Stream;
@@ -26,13 +28,18 @@ public class ClaimLineProfessionalExtensions {
   @Column(name = "clm_srvc_ddctbl_sw")
   private Optional<ClaimServiceDeductibleCode> serviceDeductibleCode;
 
-  List<Extension> toFhir() {
+  @Embedded ClaimTaxNumberCode claimTaxNumberCode;
+
+  List<Extension> toFhir(ClaimFilterOptions options) {
     return Stream.of(
             supplierTypeCode.map(ClaimSupplierTypeCode::toFhir),
             federalTypeOfServiceCode.map(ClaimFederalTypeOfServiceCode::toFhir),
             paymentCode.map(ClaimPaymentCode::toFhir),
             providerSpecialtyCode.map(ProviderSpecialtyCode::toFhirExtension),
-            serviceDeductibleCode.map(ClaimServiceDeductibleCode::toFhir))
+            serviceDeductibleCode.map(ClaimServiceDeductibleCode::toFhir),
+            options.isIncludeTaxNumber()
+                ? claimTaxNumberCode.toFhir()
+                : Optional.<Extension>empty())
         .flatMap(Optional::stream)
         .toList();
   }

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimLineProfessionalNch.java

@@ -1,5 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.converter.NonZeroDoubleConverter;
 import gov.cms.bfd.server.ng.util.FhirUtil;
 import gov.cms.bfd.server.ng.util.SystemUrls;
@@ -117,8 +118,8 @@ public List<ExplanationOfBenefit.SupportingInformationComponent> toFhirSupportin
   }
 
   @Override
-  protected List<Extension> getFhirExtensions() {
-    var extensions = new ArrayList<>(super.getFhirExtensions());
+  protected List<Extension> getFhirExtensions(ClaimFilterOptions options) {
+    var extensions = new ArrayList<>(super.getFhirExtensions(options));
     extensions.addAll(claimLineProfessionalNchExtensions.toFhir());
     return extensions;
   }

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimLineRx.java

@@ -1,5 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.util.DateUtil;
 import gov.cms.bfd.server.ng.util.FhirUtil;
 import jakarta.persistence.Column;
@@ -34,7 +35,8 @@ public Optional<Observation> toFhirObservation(int bfdRowId) {
   }
 
   @Override
-  public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent() {
+  public Optional<ExplanationOfBenefit.ItemComponent> toFhirItemComponent(
+      ClaimFilterOptions options) {
 
     var line = new ExplanationOfBenefit.ItemComponent();
     line.setSequence(1);

apps/bfd-server-ng/src/main/java/gov/cms/bfd/server/ng/claim/model/ClaimProfessionalBase.java

@@ -1,6 +1,6 @@
 package gov.cms.bfd.server.ng.claim.model;
 
-import gov.cms.bfd.server.ng.ClaimSecurityStatus;
+import gov.cms.bfd.server.ng.ClaimFilterOptions;
 import gov.cms.bfd.server.ng.util.SequenceGenerator;
 import jakarta.persistence.Column;
 import jakarta.persistence.Embedded;
@@ -63,12 +63,12 @@ void applyOutcomeOverride(ExplanationOfBenefit eob) {
 
   /** {@inheritDoc} */
   @Override
-  public ExplanationOfBenefit toFhir(ClaimSecurityStatus securityStatus) {
-    var eob = super.toFhir(securityStatus);
+  public ExplanationOfBenefit toFhir(ClaimFilterOptions options, ClaimState claimState) {
+    var eob = super.toFhir(options, claimState);
     var diagnosisSequenceGenerator = new SequenceGenerator();
     var diagnosisSequenceMap = buildDiagnosisSequences(eob, diagnosisSequenceGenerator);
 
-    getItems().forEach(item -> addClaimItemToEob(eob, item, diagnosisSequenceMap));
+    getItems().forEach(item -> addClaimItemToEob(eob, item, diagnosisSequenceMap, options));
     addProviders(eob);
     addAllSupportingInfo(eob);
     addCareTeam(eob);
@@ -85,9 +85,10 @@ public ExplanationOfBenefit toFhir(ClaimSecurityStatus securityStatus) {
   private void addClaimItemToEob(
       ExplanationOfBenefit eob,
       ClaimItemBase item,
-      Map<String, List<Integer>> diagnosisSequenceMap) {
+      Map<String, List<Integer>> diagnosisSequenceMap,
+      ClaimFilterOptions options) {
 
-    var claimLine = item.getClaimLine().toFhirItemComponent();
+    var claimLine = item.getClaimLine().toFhirItemComponent(options);
     claimLine.ifPresent(eob::addItem);
 
     // populates diagnosisSequence only if CLM_LINE_DGNS_CD is present in D-type codes