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Merge pull request #13 from CloudCray/service_type_code_cleanup
Cleans up Service Type Codes, version bump to 0.3.4
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‎README.md‎

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TigerShark is an X12 EDI message parser that can be tailored to
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a specific partner in the health care payment ecosystem.
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Version 0.3.4
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-------------
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This patch cleans up the X12 271 Service Type Codes to bring them in line with current use. This patch also includes
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parsers for the 5010 versions of Professional (X222A1) and Institutional (X223A1) 837 transactions.
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* Updates `enums.eligibility.service_type_codes` to include new and missing Service Type Codes
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* Adds `enums.eligibility.deprecated_service_type_codes`, a tuple of service type codes that have been deprecated by
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X12
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* Adds `X12_5010_X222A1` and `X12_5010_X223A1` parsers for 837 5010 messages
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* This does NOT add or update any facades related to 837 transactions (existing 837 facades only function for 4010
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messages)
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The `service_type_codes` dict was last updated in June 2012. Since then, 21 Service Type Codes have been added,
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7 of which have already been deprecated.
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13 Service Type Codes have been deprecated by X12 (including 7 added in this patch). All 13 have been
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preserved in `service_type_codes`, as this module may be used to parse existing/old 271 responses. The
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`deprecated_service_type_codes` tuple has been added as a helper to identify which codes are considered inactive.
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Note: the code `EO` ("ECHO-OSCAR") appears to have been added in error temporarily as a duplicate of `E0`
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("ECHO-ZERO") for a 4-month span in 2017. The code has been added back in on the chance it made its way into
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any production systems.
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New Service Type Codes:
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| Code | Label | Date Added | Date Deprecated |
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| --- | --- | --- | --- |
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| E29 | Technical Cardiac Rehabilitation Services Component | 09/30/2012 | 07/01/2016 |
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| E30 | Professional Cardiac Rehabilitation Services Component | 09/30/2012 | 07/01/2016 |
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| E31 | Professional Intensive Cardiac Rehabilitation Services Component | 09/30/2012 | 07/01/2016 |
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| E32 | Intensive Cardiac Rehabilitation - Technical Component | 06/02/2013 | 05/01/2017 |
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| E33 | Intensive Cardiac Rehabilitation | 06/02/2013 | |
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| E34 | Pulmonary Rehabilitation - Technical Component | 06/02/2013 | 05/01/2017 |
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| E35 | Pulmonary Rehabilitation - Professional Component | 06/02/2013 | 05/01/2017 |
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| E36 | Convenience Care | 06/02/2013 | |
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| E37 | Telemedicine | 07/01/2015 | |
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| E38 | Pharmacist Services | 07/01/2015 | |
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| E39 | Diabetic Education | 03/01/2016 | |
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| E40 | Early Intervention | 11/01/2016 | |
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| EO | Applied Behavioral Analysis Therapy | 03/01/2017 | 07/01/2017 |
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| F1 | Medical Coverage | 11/01/2015 | |
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| F2 | Social Work Coverage | 11/01/2015 | |
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| F3 | Dental Coverage | 11/01/2015 | |
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| F4 | Hearing Coverage | 11/01/2015 | |
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| F5 | Prescription Drug Coverage | 11/01/2015 | |
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| F6 | Vision Coverage | 11/01/2015 | |
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| F7 | Orthodontia Coverage | 11/01/2015 | |
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| F8 | Mental Health Coverage | 11/01/2015 | |
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More on service type codes on the [official X12 website](https://x12.org/codes/service-type-codes).
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* _Note: Use the
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"Show All" filter to view current and deprecated codes (page only displays current codes by default.)_
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Version 0.3.3
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-------------
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‎tests/5010-837-institutional-example.txt‎

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ISA*00* *00* *ZZ*1234567 *ZZ*11111 *170508*1141*^*00501*000000101*1*P*:~
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GS*HC*XXXXXXX*XXXXX*20170617*1741*101*X*005010X223A2~
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ST*837*987654*005010X223A2~
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BHT*0019*00*0123*19960918*0932*CH~
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NM1*41*2*JONES HOSPITAL*****46*12345~
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PER*IC*JANE DOE*TE*9005555555~
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NM1*40*2*MEDICARE*****46*00120~
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HL*1**20*1~
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PRV*BI*PXC*203BA0200N~
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NM1*85*2*JONES HOSPITAL*****XX*9876540809~
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N3*225 MAIN STREET BARKLEY BUILDING~
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N4*CENTERVILLE*PA*17111~
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REF*EI*567891234~
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PER*IC*CONNIE*TE*3055551234~
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HL*2*1*22*0~
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SBR*P*18*******MB~
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NM1*IL*1*DOE*JOHN*T***MI*030005074A~
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N3*125 CITY AVENUE~
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N4*CENTERVILLE*PA*17111~
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DMG*D8*19261111*M~
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NM1*PR*2*MEDICARE B*****PI*00435~
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REF*G2*330127~
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CLM*756048Q*89.93**14:A:1*A*Y*Y~
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DTP*434*RD8*19960911~
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CL1*3**01~
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HI*BK:3669~
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HI*BF:4019*BF:79431~
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HI*BH:A1:D8:19261111*BH:A2:D8:19911101*BH:B1:D8:19261111*BH:B2:D8:19870101~
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HI*BE:A2:::15.31~
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HI*BG:09~
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NM1*71*1*JONES*JOHN*J~
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REF*1G*B99937~
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SBR*S*01*351630*STATE TEACHERS*****CI~
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OI***Y***Y~
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NM1*IL*1*DOE*JANE*S***MI*222004433~
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N3*125 CITY AVENUE~
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N4*CENTERVILLE*PA*17111~
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NM1*PR*2*STATE TEACHERS*****PI*1135~
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LX*1~
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SV2*0305*HC:85025*13.39*UN*1~
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DTP*472*D8*19960911~
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LX*2~
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SV2*0730*HC:93005*76.54*UN*3~
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DTP*472*D8*19960911~
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SE*42*987654~
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GE*1*101~
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GS*HC*XXXXXXX*XXXXX*20170617*1741*101*X*005010X223A2~
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ST*837*987654*005010X223A2~
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BHT*0019*00*0123*19960918*0932*CH~
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NM1*41*2*JONES HOSPITAL*****46*12345~
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PER*IC*JANE DOE*TE*9005555555~
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NM1*40*2*MEDICARE*****46*00120~
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HL*1**20*1~
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PRV*BI*PXC*203BA0200N~
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NM1*85*2*JONES HOSPITAL*****XX*9876540809~
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N3*225 MAIN STREET BARKLEY BUILDING~
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N4*CENTERVILLE*PA*17111~
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REF*EI*567891234~
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PER*IC*CONNIE*TE*3055551234~
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HL*2*1*22*0~
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SBR*P*18*******MB~
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NM1*IL*1*DOE*JOHN*T***MI*030005074A~
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N3*125 CITY AVENUE~
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N4*CENTERVILLE*PA*17111~
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DMG*D8*19261111*M~
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NM1*PR*2*MEDICARE B*****PI*00435~
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REF*G2*330127~
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CLM*756048Q*89.93**14:A:1*A*Y*Y~
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DTP*434*RD8*19960911~
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CL1*3**01~
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HI*BK:3669~
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HI*BF:4019*BF:79431~
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HI*BH:A1:D8:19261111*BH:A2:D8:19911101*BH:B1:D8:19261111*BH:B2:D8:19870101~
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HI*BE:A2:::15.31~
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HI*BG:09~
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NM1*71*1*JONES*JOHN*J~
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REF*1G*B99937~
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SBR*S*01*351630*STATE TEACHERS*****CI~
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OI***Y***Y~
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NM1*IL*1*DOE*JANE*S***MI*222004433~
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N3*125 CITY AVENUE~
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N4*CENTERVILLE*PA*17111~
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NM1*PR*2*STATE TEACHERS*****PI*1135~
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LX*1~
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SV2*0305*HC:85025*13.39*UN*1~
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DTP*472*D8*19960911~
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LX*2~
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SV2*0730*HC:93005*76.54*UN*3~
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DTP*472*D8*19960911~
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SE*42*987654~
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GE*1*101~
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IEA*1*000000101~

‎tests/5010-837-professional-example.txt‎

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ISA*00* *00* *ZZ*1234567 *ZZ*11111 *170508*1141*^*00501*000000101*1*P*:~
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GS*HC*XXXXXXX*XXXXX*20170617*1741*101*X*005010X222A1~
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ST*837*1239*005010X222A1~
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BHT*0019*00*010*20170617*1741*CH~
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NM1*41*2*SUBMITTER*****46*ABC123~
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PER*IC*BOB SMITH*TE*4805551212~
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NM1*40*2*RECEIVER*****46*44556~
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HL*1**20*1~
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NM1*85*2*BILLING PROVIDER*****XX*1122334455~
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N3*1234 SOME ROAD~
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N4*CHICAGO*IL*606739999~
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REF*EI*999999999~
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HL*2*1*22*0~
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SBR*P*18*******12~
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NM1*IL*1*BLOGGS*JOE****MI*1234567890~
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N3*1 SOME BLVD~
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N4*CHICAGO*IL*606129998~
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DMG*D8*19570111*M~
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NM1*PR*2*PAYER*****PI*12345~
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N3*1 PAYER WAY~
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N4*ST LOUIS*MO*212441850~
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REF*2U*W1014~
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CLM*1000A*140***19:B:1*Y*A*Y*Y~
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HI*ABK:I10~
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LX*1~
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SV1*HC:99213*140*UN*1***1~
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DTP*472*D8*20151124~
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HL*3*1*22*0~
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SBR*P*18*******12~
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NM1*IL*1*BLOGGS*FRED****MI*9876543201~
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N3*1 ANOTHER STR~
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N4*CHICAGO*IL*606129998~
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DMG*D8*19700601*M~
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NM1*PR*2*PAYER*****PI*12345~
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N3*1 PAYER WAY~
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N4*ST LOUIS*MO*212441850~
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REF*2U*W1014~
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CLM*1001A*140***19:B:1*Y*A*Y*Y~
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HI*ABK:I10~
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LX*1~
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SV1*HC:99213*140*UN*1***1~
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DTP*472*D8*20151124~
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SE*41*1239~
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GE*1*101~
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IEA*1*000000101~

‎tests/test_5010_837I.py‎

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import datetime
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from decimal import Decimal
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import unittest
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from tigershark.parsers.M837_5010_X223_A1 import parsed_837
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class TestParserX223A1(unittest.TestCase):
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def test_financial_information(self):
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with open('tests/5010-837-institutional-example.txt') as f:
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parsed = parsed_837.unmarshall(f.read().strip())
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segments = parsed.segs()
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self.assertEqual(len(segments), 92)
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self.assertEqual(
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[str(x) for x in segments[1].elements],
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[
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"GS",
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"HC",
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"XXXXXXX",
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"XXXXX",
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"20170617",
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"1741",
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"101",
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"X",
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"005010X223A2"
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]
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)
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segment_first_nm1 = parsed.descendant("segment", "NM1")[0]
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self.assertEqual(
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[str(x) for x in segment_first_nm1.elements],
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[
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"NM1",
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"41",
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"2",
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"JONES HOSPITAL",
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"",
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"",
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"",
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"",
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"46",
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"12345"
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]
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)

‎tests/test_5010_837P.py‎

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import datetime
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from decimal import Decimal
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import unittest
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from tigershark.parsers.M837_5010_X222_A1 import parsed_837
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class TestParserX222A1(unittest.TestCase):
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def test_financial_information(self):
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with open('tests/5010-837-professional-example.txt') as f:
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parsed = parsed_837.unmarshall(f.read().strip())
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segments = parsed.segs()
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self.assertEqual(len(segments), 45)
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self.assertEqual(
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[str(x) for x in segments[1].elements],
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[
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"GS",
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"HC",
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"XXXXXXX",
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"XXXXX",
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"20170617",
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"1741",
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"101",
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"X",
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"005010X222A1"
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]
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)
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segment_first_nm1 = parsed.descendant("segment", "NM1")[0]
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self.assertEqual(
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[str(x) for x in segment_first_nm1.elements],
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[
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"NM1",
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"41",
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"2",
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"SUBMITTER",
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"",
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"",
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"",
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"",
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"46",
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"ABC123"
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]
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)

‎tigershark/__init__.py‎

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TigerShark - An X12 EDI message parser.
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"""
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__all__ = ['X12VersionTuple']
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__version__ = "0.3.3"
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__version__ = "0.3.4"
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__authors__ = [
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"Steven Buss <[email protected]>",
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"Steven Lott <[email protected]>",
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"Dave Peticolas <[email protected]>",
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"Cloud Cray <[email protected]>",
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]
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from collections import namedtuple
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X12_4010_XXXC = X12VersionTuple.for_4010('XXXC')
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X12_5010_X221A1 = X12VersionTuple.for_5010('X221A1')
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X12_5010_X279A1 = X12VersionTuple.for_5010('X279A1')
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X12_5010_X222A1 = X12VersionTuple.for_5010('X222A1')
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X12_5010_X223A1 = X12VersionTuple.for_5010('X223A1')

‎tigershark/facade/enums/eligibility.py‎

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"E26": "Comprehensive Medication Therapy Management Review",
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"E27": "Targeted Medication Therapy Management Review",
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"E28": "Dietary/Nutritional Services",
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"E29": "Technical Cardiac Rehabilitation Services Component",
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"E30": "Professional Cardiac Rehabilitation Services Component",
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"E31": "Professional Intensive Cardiac Rehabilitation Services Component",
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"E32": "Intensive Cardiac Rehabilitation - Technical Component",
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"E33": "Intensive Cardiac Rehabilitation",
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"E34": "Pulmonary Rehabilitation - Technical Component",
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"E35": "Pulmonary Rehabilitation - Professional Component",
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"E36": "Convenience Care",
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"E37": "Telemedicine",
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"E38": "Pharmacist Services",
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"E39": "Diabetic Education",
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"E40": "Early Intervention",
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"EA": "Preventive Services",
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"EB": "Specialty Pharmacy",
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"EC": "Durable Medical Equipment New",
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"ED": "CAT Scan",
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"EE": "Ophthalmology",
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"EF": "Contact Lenses",
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"EO": "Allied Behavioral Analysis Therapy",
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"F1": "Medical Coverage",
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"F2": "Social Work Coverage",
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"F3": "Dental Coverage",
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"F4": "Hearing Coverage",
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"F5": "Prescription Drug Coverage",
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"F6": "Vision Coverage",
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"F7": "Orthodontia Coverage",
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"F8": "Mental Health Coverage",
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"GF": "Generic Prescription Drug - Formulary",
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"GN": "Generic Prescription Drug - Non-Formulary",
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"GY": "Allergy",
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"UC": "Urgent Care",
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}
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deprecated_service_type_codes = (
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"34",
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"BW",
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"BX",
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"E12",
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"E13",
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"E24",
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"E29",
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"E30",
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"E31",
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"E32",
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"E34",
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"E35",
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"EO",
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)
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coverage_level = {
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"CHD": "Children Only",
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"DEP": "Dependents Only",

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