feat(parsers+api+ui): expose CARC-labeled CAS adjustments (SP3 P2)

This commit is contained in:
Tyler
2026-06-20 07:44:41 -06:00
parent 76eb33e029
commit 2a853857b1
10 changed files with 927 additions and 26 deletions
+87 -2
View File
@@ -335,14 +335,23 @@ def to_ui_remittance(
f"CLP02 code {code} not in payer allowlist"
)
# Aggregate adjustmentAmount across ALL service-line CAS rows, not just
# the first line. Mirrors the SUM the reconcile aggregator (T10)
# computes against persisted CasAdjustment rows; this inline version
# is the write-path equivalent (used when streaming 835 NDJSON
# responses before persistence finishes).
adjustment_total = Decimal("0")
for sp in cp.service_payments:
for adj in sp.adjustments:
adjustment_total += adj.amount
parsed_iso = parsed_at.isoformat().replace("+00:00", "Z")
return {
"id": cp.payer_claim_control_number,
"claimId": cp.original_claim_id or "",
"payerName": payer_name,
"paidAmount": float(cp.total_paid or 0.0),
# TODO: aggregate from CAS segments when reconciliation lands (sub-project 2)
"adjustmentAmount": 0.0,
"adjustmentAmount": float(adjustment_total),
"status": status,
"denialReason": denial_reason,
"validationWarnings": validation_warnings,
@@ -443,6 +452,53 @@ def to_ui_remittance_from_orm(
}
def to_ui_remittance_with_adjustments(
row: Remittance,
*,
batch_id: str,
parsed_at: datetime,
cas_rows: list["db.CasAdjustment"] | None = None,
) -> dict:
"""Same shape as :func:`to_ui_remittance_from_orm` plus an ``adjustments`` array.
Each persisted ``CasAdjustment`` row is rendered as
``{"group", "reason", "label", "amount", "quantity"}``. The ``label``
is resolved through :func:`cyclone.parsers.cas_codes.reason_label`
so the UI does not have to ship its own CARC dictionary.
``cas_rows`` is optional so callers that don't have the rows handy
can still get the base dict; in that case ``adjustments`` is ``[]``.
Pass ``cas_rows`` to avoid an extra round-trip; the endpoint at
``GET /api/remittances/{id}`` passes them in to keep this mapper a
pure function.
"""
base = to_ui_remittance_from_orm(
row, batch_id=batch_id, parsed_at=parsed_at,
)
if not cas_rows:
base["adjustments"] = []
return base
# Lazy import to avoid the circular store ↔ parsers import that
# happens on cold start; mirrors the same pattern used elsewhere
# in this module.
from cyclone.parsers.cas_codes import reason_label
base["adjustments"] = [
{
"group": c.group_code,
"reason": c.reason_code,
"label": reason_label(c.group_code, c.reason_code),
"amount": float(c.amount or 0),
"quantity": (
float(c.quantity) if c.quantity is not None else None
),
}
for c in cas_rows
]
return base
def to_ui_provider(
*,
npi: str,
@@ -766,6 +822,35 @@ class CycloneStore:
)
return [self._row_to_record(r) for r in rows]
def get_remittance(self, remittance_id: str) -> dict | None:
"""Return a UI-shaped remittance dict with ``adjustments`` array.
Joins the persisted ``CasAdjustment`` rows for ``remittance_id``
and labels each via :mod:`cyclone.parsers.cas_codes`. Returns
``None`` when the remittance is not found so the API layer can
map that to a 404.
"""
with db.SessionLocal()() as s:
row = s.get(Remittance, remittance_id)
if row is None:
return None
cas_rows = (
s.query(CasAdjustment)
.filter(CasAdjustment.remittance_id == remittance_id)
.all()
)
parsed_at = (
row.batch.parsed_at if row.batch is not None else row.received_at
)
if parsed_at is not None and parsed_at.tzinfo is None:
parsed_at = parsed_at.replace(tzinfo=timezone.utc)
return to_ui_remittance_with_adjustments(
row,
batch_id=row.batch_id,
parsed_at=parsed_at,
cas_rows=cas_rows,
)
def all(self) -> list[BatchRecord]:
"""Return every ``BatchRecord``, oldest first (no pagination)."""
with db.SessionLocal()() as s: