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1ddeb51 | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 | """Align UI encounter types to specialty Schedule listings by care setting.
Specialty **26 (Paediatrics)** and **00 (Family Practice)** use different
Consultations and Visits sections. Encounter labels map to letter-prefix
families plus BM25 steering keywords for that specialty.
"""
from __future__ import annotations
from .specialty_registry import normalize_specialty_code
# Ordered (substring -> (prefixes, keywords)) rules. First match wins — more
# specific Paediatrics phrases must precede generic ones.
_PAEDS_RULES: list[tuple[tuple[str, ...], tuple[list[str], str]]] = [
# --- Newborn & delivery (H261 / H267 live in PAEDIATRICS (26)) ---
(
("maternal delivery", "attendance at maternal", "delivery attendance"),
(["H"], "attendance at maternal delivery H267 Paediatrics"),
),
(
("newborn",),
(["H"], "newborn care in hospital or home H261 Paediatrics"),
),
# --- Prenatal (before hospital so "Hospital - Prenatal …" keeps A+C) ---
# SoB PAEDIATRICS (26) lists A665 with the same-section alternatives below;
# keep them in-scope so limited/repeat/MSA can be recommended when prenatal
# elements are not met.
(
("prenatal",),
(
["A", "C"],
"prenatal consultation A665 C665 Paediatrics "
"limited consultation A565 repeat consultation A266 "
"medical specific assessment A263 A264 A661 "
"level 1 level 2 paediatric assessment A261 A262",
),
),
# --- Long-term care (must precede generic 'complex') ---
(
("long-term", "long term", "continuing care", "ltc"),
(
["W"],
"long-term care paediatric consultation subsequent visit "
"periodic health visit",
),
),
# --- Hospital in-patient (C-series Paediatrics mirrors) ---
# Before developmental so "Hospital - … Neurodevelopmental" stays C.
(
("subsequent", "concurrent", "daily round"),
(
["C"],
"hospital in-patient subsequent visit concurrent care "
"medical specific re-assessment",
),
),
(
("hospital", "admission", "inpatient", "in-patient", "mrp"),
(
["C"],
"hospital in-patient paediatric consultation medical specific "
"assessment concurrent care neurodevelopmental",
),
),
# --- Ambulatory consultations (before developmental; "neurodevelopmental
# consultation" is an A/C/W consult listing, not K developmental care) ---
(
("well-baby", "well baby", "18 month", "18-month", "enhanced 18"),
(
["A"],
"enhanced 18 month well baby visit A268 Paediatrics",
),
),
(
(
"special paediatric",
"extended special",
"neurodevelopmental consultation",
"special / extended",
"consultation / limited",
"specialist consultation",
"consultation",
),
(
["A"],
"paediatric consultation limited repeat special extended "
"neurodevelopmental A260 A265 A565 A266 A662 A667 A695",
),
),
(
("medical specific", "level 2", "general assessment"),
(
["A"],
"level 2 paediatric assessment medical specific assessment "
"re-assessment A262 A263 A264 A661",
),
),
(
("level 1", "partial", "recheck", "minor"),
(
["A"],
"level 1 paediatric assessment A261",
),
),
# --- Developmental / behavioural care (K119 / K122 / K123) ---
# Narrow needles so "neurodevelopmental consultation" stays on A/C/W.
(
(
"developmental -",
"behavioural care",
"behavioral care",
"developmental care",
"developmental assessment incentive",
"family developmental",
"individual developmental",
),
(
["K", "A"],
"paediatric developmental behavioural care K119 K122 K123 "
"neurodevelopmental",
),
),
# --- Interprofessional / case conference ---
(
(
"case conference",
"multi-disciplinary",
"multidisciplinary",
"inter-professional",
"interprofessional",
),
(
["K"],
"developmental behavioural care case conference "
"interprofessional special services",
),
),
# --- Virtual: audio/telephone before generic "virtual" ---
(
("audio", "telephone"),
(
["A"],
"office paediatric assessment consultation virtual telephone",
),
),
(
("virtual", "video"),
(["A"], "office paediatric assessment consultation virtual video"),
),
(
("ambulatory", "office", "outpatient"),
(
["A"],
"paediatric assessment consultation well baby office ambulatory",
),
),
# --- Emergency: Paediatrics (26) only lists newborn/delivery under H ---
(
("emergency",),
(
["H", "A"],
"paediatric assessment consultation emergency urgent",
),
),
]
# Family Practice (00) — A001/A007/A003 ladder + hospital/LTC/K017.
_FP_RULES: list[tuple[tuple[str, ...], tuple[list[str], str]]] = [
(
("periodic health", "annual health", "complete physical"),
(
["K", "A"],
"periodic health visit K017 Family Practice office",
),
),
(
("long-term", "long term", "continuing care", "ltc", "nursing home"),
(
["W"],
"long-term care subsequent visit periodic health W001 W002 W003 "
"W004 W109 Family Practice",
),
),
(
("subsequent", "concurrent", "supportive", "daily round"),
(
["C"],
"hospital in-patient subsequent visit concurrent care supportive "
"care C002 C007 C008 C010 Family Practice",
),
),
(
("hospital", "admission", "inpatient", "in-patient", "mrp"),
(
["C"],
"hospital in-patient general assessment consultation "
"C003 C004 C005 C006 Family Practice",
),
),
# Intermediate before well-baby so "Intermediate assessment / well baby care"
# steers to A007; pure enhanced-18 / well-baby labels still hit the next rule.
(
("intermediate",),
(
["A"],
"intermediate assessment A007 Family Practice",
),
),
(
("well-baby", "well baby", "18 month", "18-month", "enhanced 18"),
(
["A"],
"well baby care A007 enhanced 18 month well baby visit A002 "
"Family Practice",
),
),
# Ambulatory consult → office A only (hospital C mirrors stay on Hospital rules).
(
("repeat consultation", "repeat consult"),
(
["A"],
"repeat consultation A006 Family Practice office",
),
),
(
("consultation", "consult"),
(
["A"],
"consultation repeat consultation A006 Family Practice office",
),
),
(
("general assessment", "complete assessment", "comprehensive"),
(
["A"],
"general assessment A003 Family Practice",
),
),
(
("re-assessment", "reassessment", "general re"),
(
["A"],
"general re-assessment A004 Family Practice",
),
),
(
("mini",),
(
["A"],
"mini assessment A008 Family Practice",
),
),
(
("minor", "brief", "focused", "single complaint"),
(
["A"],
"minor assessment A001 Family Practice",
),
),
(
("audio", "telephone", "virtual", "video"),
(
["A"],
"office assessment Family Practice virtual visit A001 A007 A003",
),
),
(
("ambulatory", "office", "outpatient", "clinic"),
(
["A"],
"office assessment Family Practice A001 A007 A003 A004 A008",
),
),
(
("emergency", "urgent"),
(
["A", "H"],
"office assessment urgent Family Practice A001 A007",
),
),
]
def align_encounter(
encounter_type: str | None,
specialty_code: str | None = None,
) -> tuple[list[str], str]:
"""Return (preferred code prefixes, specialty steering keywords)."""
if not encounter_type:
return [], ""
et = encounter_type.lower()
code = normalize_specialty_code(specialty_code)
rules = _FP_RULES if code == "00" else _PAEDS_RULES
for needles, result in rules:
if any(n in et for n in needles):
return list(result[0]), result[1]
return [], ""
def prefix_filter(prefixes: list[str]) -> list[dict]:
"""OpenSearch filter clause restricting billing_code to the given prefixes."""
if not prefixes:
return []
return [
{
"bool": {
"should": [{"prefix": {"billing_code": p}} for p in prefixes],
"minimum_should_match": 1,
}
}
]
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