Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import type { Bundle, Claim } from '@medplum/fhirtypes'; import express from 'express'; import request from 'supertest'; import { initApp, shutdownApp } from '../../app'; import { loadTestConfig } from '../../config/loader'; import { initTestAuth } from '../../test.setup'; const app = express(); let accessToken: string; describe('CMS 1500 PDF', () => { beforeAll(async () => { const config = await loadTestConfig(); await initApp(app, config); accessToken = await initTestAuth(); }); afterAll(async () => { await shutdownApp(); }); test('Post Request - Fully answered CMS1500 pdf', async () => { const bundleRes = await request(app) .post(`/fhir/R4`) .set('Authorization', 'Bearer ' + accessToken) .set('Content-Type', 'application/fhir+json') .send(fullAnswer); expect(bundleRes.status).toBe(200); expect(bundleRes.body.resourceType).toBe('Bundle'); expect(bundleRes.body.type).toBe('transaction-response'); const searchRes = await request(app) .get(`/fhir/R4/Claim?identifier=example-claim-cms1500`) .set('Authorization', 'Bearer ' + accessToken) .set('Accept', 'application/fhir+json'); expect(searchRes.status).toBe(200); expect(searchRes.body.resourceType).toBe('Bundle'); expect(searchRes.body.entry.length).toBeGreaterThan(0); const claim = searchRes.body.entry[0].resource as Claim; expect(claim.resourceType).toBe('Claim'); expect(claim.identifier?.some((id) => id.value === 'example-claim-cms1500')).toBe(true); const response = await request(app) .post(`/fhir/R4/Claim/$export`) .set('Authorization', 'Bearer ' + accessToken) .set('Accept', 'application/fhir+json') .send({ resourceType: 'Parameters', parameter: [ { name: 'resource', resource: claim, }, ], }); expect(response).toBeDefined(); expect(response.status).toBe(200); expect(response.body.resourceType).toBe('Media'); expect(response.body.content.contentType).toBe('application/pdf'); }); test('Get Request - Fully answered CMS1500 pdf', async () => { const bundleRes = await request(app) .post(`/fhir/R4`) .set('Authorization', 'Bearer ' + accessToken) .set('Content-Type', 'application/fhir+json') .send(fullAnswer); expect(bundleRes.status).toBe(200); expect(bundleRes.body.resourceType).toBe('Bundle'); expect(bundleRes.body.type).toBe('transaction-response'); const searchRes = await request(app) .get(`/fhir/R4/Claim?identifier=example-claim-cms1500`) .set('Authorization', 'Bearer ' + accessToken) .set('Accept', 'application/fhir+json'); expect(searchRes.status).toBe(200); expect(searchRes.body.resourceType).toBe('Bundle'); expect(searchRes.body.entry.length).toBeGreaterThan(0); const claim = searchRes.body.entry[0].resource as Claim; expect(claim.resourceType).toBe('Claim'); expect(claim.identifier?.some((id) => id.value === 'example-claim-cms1500')).toBe(true); const response = await request(app) .get(`/fhir/R4/Claim/${claim.id}/$export`) .set('Authorization', 'Bearer ' + accessToken) .set('Accept', 'application/fhir+json'); expect(response).toBeDefined(); expect(response.status).toBe(200); expect(response.body.resourceType).toBe('Media'); expect(response.body.content.contentType).toBe('application/pdf'); }); test('Bad request - claim not found', async () => { const response = await request(app) .get(`/fhir/R4/Claim/non-existent-id/$export`) .set('Authorization', 'Bearer ' + accessToken) .set('Accept', 'application/fhir+json'); expect(response.status).toBe(400); expect(response.body.resourceType).toBe('OperationOutcome'); expect(response.body.issue[0].severity).toBe('error'); }); test('Bad request - claim not found', async () => { const response = await request(app) .post(`/fhir/R4/Claim/$export`) .set('Authorization', 'Bearer ' + accessToken) .set('Accept', 'application/fhir+json') .send({ resourceType: 'Parameters', parameter: [{ name: 'resource' }], }); expect(response.status).toBe(400); expect(response.body.resourceType).toBe('OperationOutcome'); expect(response.body.issue[0].severity).toBe('error'); }); }); export const fullAnswer: Bundle = { resourceType: 'Bundle', type: 'transaction', entry: [ { fullUrl: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945', request: { method: 'PUT', url: 'Patient?name=Homer%20Simpson' }, resource: { resourceType: 'Patient', name: [ { given: ['Homer'], family: 'Simpson', }, ], birthDate: '1956-05-12', gender: 'male', address: [ { line: ['742 Evergreen Terrace'], city: 'Springfield', state: 'IL', postalCode: '62704', }, ], telecom: [ { system: 'phone', use: 'mobile', value: '555-555-6392', }, ], }, }, { fullUrl: 'urn:uuid:7914fb49-05e1-45cc-bffc-a3fdff1b72e1', request: { method: 'PUT', url: 'RelatedPerson?name=Marge%20Simpson' }, resource: { resourceType: 'RelatedPerson', patient: { reference: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945' }, name: [{ given: ['Marge'], family: 'Simpson' }], birthDate: '1960-08-12', gender: 'female', address: [ { line: ['742 Evergreen Terrace'], city: 'Springfield', state: 'IL', postalCode: '62704', }, ], telecom: [ { system: 'phone', use: 'mobile', value: '555-555-6393', }, ], }, }, { fullUrl: 'urn:uuid:e2523da4-9d6e-442c-99aa-fcfe3353c9e3', request: { method: 'PUT', url: 'RelatedPerson?name=Abraham%20Simpson' }, resource: { resourceType: 'RelatedPerson', patient: { reference: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945' }, name: [{ given: ['Abraham'], family: 'Simpson' }], birthDate: '1927-06-04', gender: 'male', address: [ { line: ['Springfield Retirement Castle'], city: 'Springfield', state: 'IL', postalCode: '62704', }, ], }, }, { fullUrl: 'urn:uuid:706245c5-5f9d-45eb-bf90-cee2fac3f52c', request: { method: 'PUT', url: 'Practitioner?identifier=2490433892' }, resource: { resourceType: 'Practitioner', identifier: [ { system: 'http://hl7.org/fhir/sid/us-npi', value: '2490433892', }, ], name: [ { given: ['Kevin'], family: 'Smith', }, ], address: [ { line: ['2904 Main Street'], city: 'Elizabeth', state: 'MD', country: 'US', postalCode: '21219', }, ], telecom: [ { use: 'work', system: 'phone', value: '555-555-9391', }, ], }, }, { fullUrl: 'urn:uuid:f1ed24bf-7efa-44a1-b5ea-cc46414a282d', request: { method: 'PUT', url: 'Organization?identifier=7911621876' }, resource: { resourceType: 'Organization', identifier: [ { use: 'official', system: 'http://hl7.org/fhir/sid/us-npi', value: '7911621876', }, { use: 'official', type: { coding: [ { system: 'http://example.org/org-id', code: 'TAX', }, ], }, value: '5551844680', system: 'http://example-systemt.org/tax', }, ], name: 'Independence Blue Cross Blue Shield', address: [ { line: ['1901 Market Street'], city: 'Philadelphia', state: 'PA', postalCode: '19103', type: 'both', }, ], telecom: [ { system: 'phone', use: 'work', value: '555-555-4321', }, ], }, }, { fullUrl: 'urn:uuid:4bc72375-425d-4fb0-be6e-38bc6144d1e5', request: { method: 'PUT', url: 'Organization?identifier=5746217289' }, resource: { resourceType: 'Organization', identifier: [ { use: 'official', system: 'http://hl7.org/fhir/sid/us-npi', value: '5746217289', }, { use: 'official', type: { coding: [ { system: 'http://example.org/org-id', code: 'TAX', }, ], }, value: '5554404734', system: 'http://example-systemt.org/tax', }, ], name: 'Medicare Insurance', address: [ { line: ['2578 Elmwood Avenue'], city: 'Chicago', state: 'IL', postalCode: '60610', type: 'both', }, ], }, }, { fullUrl: 'urn:uuid:72ec6c80-6dab-41e0-adff-a8670a5b4363', request: { method: 'PUT', url: 'Coverage?identifier=89442808' }, resource: { resourceType: 'Coverage', identifier: [ { use: 'official', value: '89442808', }, ], status: 'active', beneficiary: { reference: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945', display: 'Homer Simpson', }, payor: [ { reference: 'urn:uuid:f1ed24bf-7efa-44a1-b5ea-cc46414a282d', display: 'Independence Blue Cross Blue Shield', }, ], type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/v3-ActCode', code: 'HIP', display: 'health insurance plan policy', }, ], }, relationship: { coding: [ { system: 'http://hl7.org/fhir/ValueSet/subscriber-relationship', code: 'spouse', display: 'Spouse', }, ], }, subscriber: { reference: 'urn:uuid:7914fb49-05e1-45cc-bffc-a3fdff1b72e1', display: 'Marge Simpson', }, class: [ { type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/coverage-class', code: 'plan', }, ], }, value: 'B37FC', name: 'Independence Blue Full Coverage', }, { type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/coverage-class', code: 'group', }, ], }, value: '123456789', name: 'Independence Blue Group Plan', }, ], }, }, { fullUrl: 'urn:uuid:10e49ae1-acf1-4288-93d3-5bbb504957aa', request: { method: 'PUT', url: 'Coverage?identifier=21173018' }, resource: { resourceType: 'Coverage', identifier: [ { use: 'official', value: '21173018', }, ], status: 'active', beneficiary: { reference: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945', display: 'Homer Simpson', }, payor: [ { reference: 'urn:uuid:4bc72375-425d-4fb0-be6e-38bc6144d1e5', display: 'Medicare Insurance', }, ], type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/v3-ActCode', code: 'EHCPOL', display: 'extended healthcare', }, ], }, relationship: { coding: [ { system: 'http://hl7.org/fhir/ValueSet/subscriber-relationship', code: 'child', display: 'Child', }, ], }, subscriber: { reference: 'urn:uuid:e2523da4-9d6e-442c-99aa-fcfe3353c9e3', display: 'Abraham Simpson', }, class: [ { type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/coverage-class', code: 'plan', }, ], }, value: '11461128', name: 'Medicare Gold Plus', }, ], }, }, { fullUrl: 'urn:uuid:30192746-113d-4c78-af02-3090ce22996f', request: { method: 'PUT', url: 'ServiceRequest?identifier=4839201756' }, resource: { resourceType: 'ServiceRequest', identifier: [ { system: 'http://hl7.org/fhir/sid/us-npi', value: '4839201756', }, ], status: 'active', intent: 'order', category: [ { coding: [ { system: 'http://snomed.info/sct', code: '103696004', display: 'Patient referral to specialist' }, ], }, ], subject: { reference: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945', display: 'Homer Simpson' }, requester: { reference: 'urn:uuid:706245c5-5f9d-45eb-bf90-cee2fac3f52c', display: 'Kevin Smith' }, }, }, { fullUrl: 'urn:uuid:6a86eda3-ce9e-472c-ba6b-1855e518d779', request: { method: 'PUT', url: 'Claim?identifier=example-claim-cms1500' }, resource: { resourceType: 'Claim', identifier: [ { system: 'http://example.org/claims', value: 'example-claim-cms1500', }, ], status: 'active', type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/claim-type', code: 'professional', display: 'Professional', }, ], }, use: 'claim', patient: { reference: 'urn:uuid:8796eac7-4ee2-4b9a-84f7-68691173e945', display: 'Homer Simpson' }, created: '2020-04-17T11:15:12.614Z', priority: { coding: [ { system: 'http://hl7.org/fhir/ValueSet/process-priority', code: 'normal', }, ], }, referral: { reference: 'urn:uuid:30192746-113d-4c78-af02-3090ce22996f' }, insurance: [ { coverage: { reference: 'urn:uuid:72ec6c80-6dab-41e0-adff-a8670a5b4363', display: 'Homer Simpson Health Insurance Plan', }, sequence: 1, focal: true, preAuthRef: ['0923092390'], }, { coverage: { reference: 'urn:uuid:10e49ae1-acf1-4288-93d3-5bbb504957aa', display: 'Abraham Simpson Extended Healthcare Plan', }, sequence: 2, focal: false, }, ], provider: { reference: 'urn:uuid:706245c5-5f9d-45eb-bf90-cee2fac3f52c', display: 'Kevin Smith' }, supportingInfo: [ { category: { coding: [ { code: 'employmentimpacted', system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory', }, ], }, sequence: 1, timingPeriod: { start: '2024-04-02', end: '2024-04-20', }, }, { category: { coding: [{ code: 'info', system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory' }], }, sequence: 2, code: { coding: [{ system: 'http://example.org/info-codes', code: 'patientaccount' }], }, valueString: '429802409', }, { category: { coding: [{ system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory', code: 'onset' }], }, sequence: 3, timingDate: '2024-02-02', }, { category: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory', code: 'hospitalized' }, ], }, sequence: 4, timingPeriod: { start: '2024-03-30', end: '2024-05-21', }, }, { category: { coding: [{ code: 'info', system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory' }], }, code: { coding: [{ system: 'http://example.org/info-codes', code: 'patientpaid' }], }, sequence: 5, valueQuantity: { value: 320, unit: 'USD', }, }, { category: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory', code: 'outsidelab' }, ], }, sequence: 6, valueQuantity: { value: 125, unit: 'USD', }, }, ], total: { currency: 'USD', value: 1000, }, diagnosis: [ { sequence: 1, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'J20', display: 'Acute bronchitis' }], }, }, { sequence: 2, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'G89.4', display: 'Chronic pain syndrome' }], }, }, { sequence: 3, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ3' }] }, }, { sequence: 4, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ4' }] }, }, { sequence: 5, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ5' }] }, }, { sequence: 6, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ6' }] }, }, { sequence: 7, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ7' }] }, }, { sequence: 8, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ8' }] }, }, { sequence: 9, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ9' }] }, }, { sequence: 10, diagnosisCodeableConcept: { coding: [{ system: 'http://hl7.org/fhir/sid/icd-10', code: 'XYZ10' }] }, }, ], related: [ { relationship: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship', code: 'prior', display: 'Prior Claim', }, ], }, }, ], accident: { date: '2024-03-30', locationAddress: { line: ['39 Green Lane'], city: 'Wichita', state: 'KS', country: 'US', }, type: { coding: [ { code: 'MVA', system: 'http://terminology.hl7.org/CodeSystem/v3-ActCode', display: 'Motor vehicle accident', }, ], }, }, item: [ { servicedDate: '2024-04-14', sequence: 1, productOrService: { coding: [{ system: 'http://hl7.org/fhir/ValueSet/service-uscls', code: '1201', display: 'Exam, recall' }], }, locationAddress: { line: ['289 Johnson Street'], city: 'Ames', state: 'IA', }, category: { coding: [{ system: 'http://example.org/claim-item-category', code: 'EMG', display: 'Emergency' }], }, modifier: [ { coding: [{ system: 'http://terminology.hl7.org/CodeSystem/modifiers', code: 'XT', display: 'None' }] }, ], diagnosisSequence: [1, 2], net: { currency: 'USD', value: 1000, }, quantity: { unit: 'days', value: 20, }, programCode: [ { coding: [ { code: 'none', system: 'http://terminology.hl7.org/CodeSystem/ex-programcode', display: 'None' }, ], }, ], }, { servicedDate: '2024-05-15', sequence: 1, productOrService: { coding: [{ system: 'http://hl7.org/fhir/ValueSet/service-uscls', code: '1200', display: 'Exam, recall' }], }, locationAddress: { line: ['289 Johnson Street'], city: 'Ames', state: 'IA', }, category: { coding: [{ system: 'http://example.org/claim-item-category', code: 'EMG', display: 'Emergency' }], }, modifier: [ { coding: [{ system: 'http://terminology.hl7.org/CodeSystem/modifiers', code: 'XY', display: 'None' }] }, ], diagnosisSequence: [1, 2], net: { currency: 'USD', value: 2000, }, quantity: { unit: 'days', value: 10, }, programCode: [ { coding: [ { code: 'none', system: 'http://terminology.hl7.org/CodeSystem/ex-programcode', display: 'None' }, ], }, ], }, ], }, }, ], };