Merged in field-group/code-primary (pull request #389)

Field group/code primary

* Code breakout function

* Merged main into field-group/code-primary

* Update prompts

* Add admit type

* Merged main into field-group/code-primary

* Updated code primary prompts

* Updated code primary prompt template


Approved-by: Alex Galarce

fieldExtraction/src/investment/one_to_n_funcs.py

@@ -242,6 +242,35 @@ def get_methodology_breakout(reimbursement_primary_answers: list[dict], filename
 
     return methodology_breakout_answers
 
+
+def get_code_breakout(answer_dicts: list[dict], filename: str):
+    code_primary_questions = FieldSet(file_path=config.FIELD_JSON_PATH, field_type="code_primary_breakout").get_prompt_dict()
+    code_breakout_answers = []
+    already_seen = {}
+    for answer_dict in answer_dicts:
+        service = answer_dict.get("CONTRACT_SERVICE_CD_OR_DESC")
+        if service:
+            code_answer_dict = already_seen.setdefault(
+                    service,
+                    string_utils.universal_json_load(
+                        llm_utils.invoke_claude(
+                            investment_prompts.CODE_PRIMARY_BREAKOUT(service, code_primary_questions),
+                            config.MODEL_ID_CLAUDE35_SONNET,
+                            filename
+                        )
+                    )
+                )
+        else:
+            code_answer_dict = {}
+        code_breakout_answers.append({**answer_dict, **code_answer_dict})
+    
+    return code_breakout_answers
+
+
+
+
+
+
 def reimbursement_tin_npi(exhibit_chunk: str, reimbursement_level_fields: FieldSet) -> tuple[dict, FieldSet]:
     """
     Extracts Reimbursement-Level TIN and NPI values from the given exhibit chunk using regex patterns. For multiple TIN/NPIs in Exhibit, assigns the field to be run as part of Reimbursement-Level Primary
@@ -296,8 +325,9 @@ def reimbursement_level(exhibit_text, filename, reimbursement_level_fields):
 
     # Later, we will only run methodology breakout for those without certain carveout indicators. We will run carveout-specific breakouts for the others
     methodology_breakout_answers = get_methodology_breakout(carveout_answers, filename)
+    code_breakout_answers = get_code_breakout(methodology_breakout_answers, filename)
 
-    return methodology_breakout_answers
+    return code_breakout_answers
 
 
 

fieldExtraction/src/prompts/investment_prompts.json

@@ -364,8 +364,8 @@
     {
         "field_name": "CPT4_PROC_CD",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Identify all Procedure (CPT or HCPCS) Codes in the text: - CPT codes are exactly 5 numeric digits (00100-99999) - HCPCS codes are 1 letter followed by 4 numbers (A0000-V9999)."
     },
     {
         "field_name": "CPT4_PROC_DESC",
@@ -376,8 +376,8 @@
     {
         "field_name": "CPT4_PROC_MOD",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Identify all CPT code modifiers in the text: Identify CPT modifiers in the text: - Modifiers are 2-character codes (alphanumeric) appended to the end of a five-character Procedure code."
     },
     {
         "field_name": "CPT4_PROC_MOD_DESC",
@@ -388,8 +388,8 @@
     {
         "field_name": "REVENUE_CD",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Identify all Revenue codes (Rev codes) in the text: - 3-4 digit numeric codes - May have 'X' as a wildcard character - Start with digits 0-9."
     },
     {
         "field_name": "REVENUE_CD_DESC",
@@ -398,10 +398,10 @@
         "prompt": "TBD"
     },
     {
-        "field_name": "DIAG_CD_01",
+        "field_name": "DIAG_CD_LIST",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Identify diagnosis codes (ICD-10) in the text: - 3-7 characters in length - First character must be a letter - Characters 2-3 must be numbers - Characters 4-7 (if present) can be numbers or letters."
     },
     {
         "field_name": "DIAG_CD_DESC",
@@ -418,8 +418,8 @@
     {
         "field_name": "FACILITY_GROUPER_CD",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Identify grouper codes (DRGs) in the text: - Basic format: 3 digits (like 123) - May include severity/risk indicators (like 123-4) - May include decimal points (like 123.45) - Maximum length of 7 characters."
     },
     {
         "field_name": "FACILITY_GROUPER_DESC",
@@ -430,8 +430,8 @@
     {
         "field_name": "LINE_NDC_NUM",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Return a list of any National Drug Code numbers present. Look for an 11-digit number of the format XXXXX-XXXX-XX."
     },
     {
         "field_name": "LINE_NDC_DESC",
@@ -440,10 +440,10 @@
         "prompt": "TBD"
     },
     {
-        "field_name": "CLAIM_ADMIT_TYPE",
+        "field_name": "CLAIM_ADMIT_TYPE_CD",
         "relationship": "one_to_n",
-        "field_type": "TBD",
-        "prompt": "TBD"
+        "field_type": "code_primary_breakout",
+        "prompt": "Identify admit type codes in the text: - Single digit numeric codes (1-9) - Used to indicate hospital admission type"
     },
     {
         "field_name": "AUTH_ADMIT_TYPE_DESC",

fieldExtraction/src/prompts/investment_prompts.py

@@ -13,6 +13,8 @@ from src.utils.string_utils import extract_text_from_delimiters
 import json
 import importlib
 
+PIPE_FORMAT_INSTRUCTIONS = "Feel free to justify your answer, but enclose your final answer in |pipes|.  If the question cannot be answered with the given context, return |N/A|."
+
 class Field:
     def __init__(self, field_dict):
         # Base Attributes
@@ -340,7 +342,24 @@ Use the text in the methodology to populate a JSON dictionary with the following
 Write your JSON dictionary below:
 """
 
-PIPE_FORMAT_INSTRUCTIONS = "Feel free to justify your answer, but enclose your final answer in |pipes|.  If the question cannot be answered with the given context, return |N/A|."
+def CODE_PRIMARY_BREAKOUT(context, questions):
+    return f"""Analyze a given medical service, found in a Payer-Provider contract:
+
+Use the text in the Service to populate a JSON dictionary with the following fields:
+
+{questions}.
+
+For each field, return a list of all codes seen for that field.
+For the CPT4_PROC_CD and CPT4_PROC_MOD fields, ensure that each item in each list corresponds with each other.
+
+If any of the codes are not found, do not write a list for that field. Simply populate the field with 'N/A'.
+
+Here is the Service to analyze:
+{context}
+
+Write the JSON dictionary below:
+"""
+
 
 def ONE_TO_ONE_SINGLE_FIELD_TEMPLATE(context, question):
     return f"""The following is a contract (or excerpt thereof).  Answer the following question: {question}