feat(sp32): extract 835 NM1*1P (service provider NPI) per ClaimPayment

This commit is contained in:
Nora
2026-07-02 16:56:01 -06:00
parent c491003287
commit d8707ba874
3 changed files with 45 additions and 3 deletions
@@ -160,6 +160,7 @@ class ClaimPayment(_Base):
ref_benefit_plan: str | None = None # REF*CE per the CO guide
service_payments: list[ServicePayment] = Field(default_factory=list)
raw_segments: list[list[str]] = Field(default_factory=list)
service_provider_npi: str | None = None # NM1*1P NM109 (Loop 2100 service provider)
@model_validator(mode="before")
@classmethod
+12 -3
View File
@@ -376,6 +376,7 @@ def _consume_claim_payment(segments: list[list[str]], idx: int) -> tuple[ClaimPa
service_payments: list[ServicePayment] = []
ref_benefit_plan: str | None = None
service_provider_npi: str | None = None
per_diem: Decimal | None = None
status_label = claim_status_label(status)
@@ -422,9 +423,16 @@ def _consume_claim_payment(segments: list[list[str]], idx: int) -> tuple[ClaimPa
except ValueError:
per_diem = None
elif s[0] == "NM1":
# Patient (QC) / service-provider (1P) — captured in raw_segments.
# The 835 spec doesn't require a structured patient model in v1.
pass
# SP32: capture service-provider NPI from NM1*1P (Loop 2100).
# NM108 (idx 8) carries the ID qualifier (typically "XX");
# NM109 (idx 9) is the value. Some senders omit NM108; accept
# both forms but require a 10-digit ID.
if len(s) > 9 and s[1] == "1P":
if len(s) > 8 and s[8] == "XX" and s[9]:
if s[9].isdigit() and len(s[9]) == 10:
service_provider_npi = s[9]
elif s[9] and s[9].isdigit() and len(s[9]) == 10:
service_provider_npi = s[9]
elif s[0] == "DTM":
# Claim-level dates — captured in raw_segments.
pass
@@ -446,6 +454,7 @@ def _consume_claim_payment(segments: list[list[str]], idx: int) -> tuple[ClaimPa
ref_benefit_plan=ref_benefit_plan,
service_payments=service_payments,
raw_segments=raw,
service_provider_npi=service_provider_npi,
),
idx,
)