feat(sp32): extract 837p NM1*82 (rendering provider NPI) per ClaimOutput

This commit is contained in:
Nora
2026-07-02 17:04:07 -06:00
parent d8707ba874
commit 4d3eef22ef
4 changed files with 83 additions and 1 deletions
+1
View File
@@ -142,6 +142,7 @@ class ClaimOutput(_Base):
subscriber: Subscriber
payer: Payer
claim: ClaimHeader
rendering_provider_npi: str | None = None # NM1*82 NM109 (Loop 2420A)
diagnoses: list[Diagnosis] = Field(default_factory=list)
service_lines: list[ServiceLine] = Field(default_factory=list)
validation: ValidationReport
+8 -1
View File
@@ -210,6 +210,7 @@ def _consume_claim(segments: list[list[str]], idx: int) -> tuple[ClaimOutput, in
service_lines: list[ServiceLine] = []
raw: list[list[str]] = [seg]
prior_auth: str | None = None
rendering_provider_npi: str | None = None
idx += 1
while idx < len(segments) and segments[idx][0] not in {"HL", "CLM", "SE"}:
@@ -226,6 +227,11 @@ def _consume_claim(segments: list[list[str]], idx: int) -> tuple[ClaimOutput, in
for code in parts[1:]:
if code:
diagnoses.append(Diagnosis(code=code, qualifier=qualifier))
elif s[0] == "NM1" and len(s) > 1 and s[1] == "82":
# SP32: capture rendering provider NPI from Loop 2420A NM1*82.
# NM108 (idx 8) is the qualifier (typically "XX"), NM109 (idx 9) is the NPI.
if len(s) > 9 and s[8] == "XX" and len(s[9]) == 10 and s[9].isdigit():
rendering_provider_npi = s[9]
elif s[0] == "LX":
line_no = int(s[1]) if len(s) > 1 and s[1].isdigit() else len(service_lines) + 1
# LX is just a separator — the actual service line data is in the next SV1.
@@ -255,6 +261,7 @@ def _consume_claim(segments: list[list[str]], idx: int) -> tuple[ClaimOutput, in
subscriber=Subscriber(first_name="", last_name="", member_id="", address=Address(line1="", city="", state="", zip="")),
payer=Payer(name="", id=""),
claim=claim_header,
rendering_provider_npi=rendering_provider_npi,
diagnoses=diagnoses,
service_lines=service_lines,
validation=ValidationReport(passed=True, errors=[], warnings=[]),
@@ -296,7 +303,7 @@ def _consume_service_line(segments: list[list[str]], idx: int, line_no: int) ->
provider_ref: str | None = None
idx += 1
while idx < len(segments) and segments[idx][0] not in {"LX", "HL", "CLM", "SE"}:
while idx < len(segments) and segments[idx][0] not in {"LX", "HL", "CLM", "SE", "NM1"}:
s = segments[idx]
raw.append(s)
if s[0] == "DTP" and len(s) > 2 and s[1] == "472":