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@@ -336,6 +336,109 @@ def test_claim_passes_shipped_sp40_local_validator():
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assert not report.errors, f"unexpected errors: {report.errors}"
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def _load_visit_rows_from_csv(path) -> list[VisitRow]:
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"""Load ``VisitRow`` records from the canonical AxisCare visits CSV shape.
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The CSV is the same shape as ``ingest/jan1-jun272026.csv`` — see
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:func:`cyclone.rebill.spot_check.parse_visits_csv` for the production
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parser. We re-parse inline here so the test does not import the
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scratch-dir script.
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"""
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import csv as _csv
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from datetime import datetime as _dt
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out: list[VisitRow] = []
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with open(path, newline="", encoding="utf-8") as f:
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reader = _csv.DictReader(f)
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for row in reader:
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raw_dos = (row.get("Visit Date") or "").strip()
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if not raw_dos:
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continue
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try:
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dos = _dt.strptime(raw_dos, "%m/%d/%Y").date()
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except ValueError:
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continue
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member_id = (row.get("Member ID") or "").strip()
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procedure = (row.get("Procedure Code") or "").strip()
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if not (member_id and procedure):
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continue
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billed_clean = (row.get("Billable Amount") or "0").replace("$", "").replace(",", "")
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try:
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billed = Decimal(billed_clean or "0")
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except Exception:
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billed = Decimal("0")
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mods_raw = (row.get("Modifiers") or "").strip()
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modifiers = tuple(m.strip() for m in mods_raw.split(",") if m.strip())
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out.append(VisitRow(
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dos=dos, member_id=member_id,
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client_name=(row.get("Client") or "").strip(),
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procedure_code=procedure, modifiers=modifiers,
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billed_amount=billed,
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icd10=(row.get("ICD-10") or "").strip() or None,
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prior_auth=(row.get("Authorization #") or "").strip() or None,
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))
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return out
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@pytest.mark.parametrize("fixture_csv", ["tests/fixtures/spot_check_visits.csv"])
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def test_every_visit_in_fixture_passes_full_pipeline(fixture_csv):
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"""For each visit in the fixture CSV, the full pipeline (build → serialize →
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SP40 local validator) passes.
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This is the "drives shipped code on the real path" test: the fixture
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CSV uses the exact same column shape and value shapes as
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``ingest/jan1-jun272026.csv`` (the production visits export), and
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each visit row runs through:
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1. :func:`cyclone.rebill.spot_check.build_claim_output` (the
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canonical helper)
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2. :func:`cyclone.parsers.serialize_837.serialize_837` (the
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shipped serializer)
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3. :func:`cyclone.parsers.validator.validate` (the shipped SP40
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local validator — 25 R-codes)
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4. :func:`cyclone.rebill.spot_check.structural_spot_check`
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(segment-class check)
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The test pins all four on real visit data; if any step regresses
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(e.g., SBR09 default flips, SVC date format breaks, NPI checksum
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changes), the test fails.
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"""
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from cyclone.parsers.payer import PayerConfig
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from cyclone.parsers.validator import validate as validate_claim
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visits = _load_visit_rows_from_csv(fixture_csv)
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assert visits, f"no visits parsed from {fixture_csv}"
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cfg = PayerConfig.co_medicaid()
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for idx, visit in enumerate(visits, start=1):
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claim_id = f"{visit.dos.strftime('%Y%m%d')}-{visit.member_id}-{idx:02d}"
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claim = build_claim_output(visit, claim_id=claim_id)
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edi = serialize_837(
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claim,
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sender_id=SENDER_ID,
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receiver_id="CO_TXIX",
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submitter_name="Dzinesco",
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submitter_contact_name="Tyler Martinez",
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submitter_contact_email="tyler@dzinesco.com",
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claim_filing_indicator_code=SBR09_DEFAULT,
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)
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# Structural segment-class check.
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struct = structural_spot_check(edi)
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assert struct.passed, (
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f"{claim_id} failed structural spot check: "
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f"missing={list(struct.missing)}"
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)
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# Shipped SP40 local validator (25 R-codes).
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report = validate_claim(claim, cfg)
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assert report.passed, (
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f"{claim_id} failed SP40 local validator: "
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f"errors={[(i.rule, i.message) for i in report.errors]}"
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)
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assert not report.errors, f"{claim_id}: unexpected errors: {report.errors}"
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# --- Helpers -----------------------------------------------------------
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Tyler Martinez