Initial import: eCW Charge Validation bot and results Portal
Snapshot of the working project as of 2026-10-23 (local 2d4d4fc), one commit with no earlier history: the tracked files were de-identified first (synthetic claim ids and patient data only; see Context.md section 7). Credentials, run logs, screenshots, claim reports and client workbooks are gitignored and not included. Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
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r"""
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conditions/bh_h_code_modifier.py — document #12: on a claim whose payer's
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name starts with "BH", an H code line (H0001-H2037) carries no modifier;
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telehealth visits are excluded (their GT stays).
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python tests\test_conditions_bh_h_code_modifier.py
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Uses hcfa_claim.html with an injected H code row, whose M1-M4 inputs carry
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the same data-fieldnames as the fixture's own rows.
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"""
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import sys
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import pathlib
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import inspect
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ROOT = pathlib.Path(__file__).resolve().parent.parent
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sys.path.insert(0, str(ROOT / "src"))
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FIXTURE = pathlib.Path(__file__).resolve().parent / "fixtures" / "hcfa_claim.html"
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UB_FIXTURE = FIXTURE.with_name("ub_claim.html")
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from ecw_bot.conditions import bh_h_code_modifier as bh # noqa: E402
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from ecw_bot.conditions.base import run_all # noqa: E402
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from ecw_bot.pages import claim_form # noqa: E402
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from ecw_bot.selectors import claim_form as sel # noqa: E402
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CASES = []
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BH = [{"Name": "BH COLORADO ACCESS"}]
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MEDICAID = [{"Name": "APM2 Medicaid"}]
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OFFICE_NOTE = {"opened": "tab", "text": "Office visit. Session Setting: Clinic."}
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TELE_NOTE = {"opened": "tab", "text": "Session Setting (PoS): TeleHealth"}
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def case(fn):
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CASES.append(fn)
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return fn
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def _inject_h_row(page, code="H0023", mods=("GT", "", "", ""),
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row_id="CPTROW_3"):
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page.evaluate(
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"""(a) => {
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const tbody = document.querySelector(
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'#claimCPTCodesTable8888888888888 tbody');
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const last = tbody.querySelector('tr:last-child');
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const tr = document.createElement('tr');
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tr.id = a.rowId;
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let html = '<td><input type="checkbox" ng-click="updateBillToIns(3)" checked></td>'
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+ '<td><input data-fieldname="claimCPTCode" value="' + a.code + '" readonly></td>'
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+ '<td><input data-fieldname="ClaimCPTPOS" type="text" value="11"></td>';
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a.mods.forEach((m, i) => {
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html += '<td><input data-fieldname="ClaimCPTMOD' + (i + 1)
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+ '" type="text" value="' + m + '"></td>';
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});
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html += '<td><input data-fieldname="ClaimCPTBilledFee" value="150.00"></td>';
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tr.innerHTML = html;
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tbody.insertBefore(tr, last);
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tr.querySelectorAll('[data-fieldname^="ClaimCPTMOD"]').forEach(el =>
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el.addEventListener('blur', () => { el.dataset.blurred = '1'; }));
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}""", {"code": code, "mods": list(mods), "rowId": row_id})
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def _mods(page, index):
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row = page.locator(sel.SEL_CPT_ROWS).nth(index)
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return [row.locator(s).first.input_value() for s in sel.SEL_CPT_MOD]
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def _data(page, ins=BH, note=OFFICE_NOTE):
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data = claim_form.extract(page)
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data["insurance"] = ins
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# The fixture's Z13.31 would fire depression_dx_pointer in run_all, and
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# the injected row has no ICD inputs for it to read.
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data["icd"] = []
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if note is not None:
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data["progress_notes"] = note
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return data
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# ── detect ───────────────────────────────────────────────────────────────────
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def _cpt(code="H0023", mod1="GT", mod2=""):
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return [{"code": "99213", "mod1": "25"},
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{"code": code, "mod1": mod1, "mod2": mod2}]
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@case
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def detect_true_for_a_bh_payer_h_code_with_a_modifier():
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for payer in ("BH COLORADO ACCESS", "BH ROCKY MTN HEALTH 2022",
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"BH ROCKY MOUNTAIN HEALTH PLANS", " bh rock mtn ub "):
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data = {"insurance": [{"Name": payer}], "cpt": _cpt(),
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"progress_notes": OFFICE_NOTE}
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assert bh.detect("C1", data) is True, payer
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@case
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def detect_true_when_only_a_later_modifier_is_set():
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data = {"insurance": BH, "cpt": _cpt(mod1="", mod2="HO"),
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"progress_notes": OFFICE_NOTE}
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assert bh.detect("C1", data) is True
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def _billed_h(billed=True, fee="150.00", mod1="GT"):
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return [{"code": "99213", "billed": True, "billed_fee": "210.00"},
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{"code": "H0023", "mod1": mod1, "billed": billed,
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"billed_fee": fee}]
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@case
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def detect_true_for_a_billed_h_code_on_a_non_bh_payer():
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"""
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Operator, 2026-10-12: an H code is billed to BH payers only; on any
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other payer it is unchecked and zeroed — telehealth or not, modifier
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or not.
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"""
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for payer in ("Carelon Behavioral Health, Inc", "APM2 Medicaid",
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"HCFA Medicare", "Rocky Mountain Health Prime"):
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for note in (OFFICE_NOTE, TELE_NOTE):
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for mod1 in ("GT", ""):
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data = {"insurance": [{"Name": payer}],
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"cpt": _billed_h(mod1=mod1), "progress_notes": note}
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assert bh.detect("C1", data) is True, (payer, note, mod1)
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@case
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def detect_true_for_a_non_bh_ub_h_line_with_a_fee_and_no_checkbox():
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data = {"insurance": MEDICAID, "cpt": _billed_h(billed=None)}
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assert bh.detect("C1", data) is True
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@case
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def detect_false_for_a_non_bh_h_code_already_unchecked_and_zeroed():
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for billed, fee in ((False, "150.00"), (None, "0.00"), (True, "0.00")):
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data = {"insurance": MEDICAID, "cpt": _billed_h(billed, fee)}
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assert bh.detect("C1", data) is False, (billed, fee)
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@case
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def detect_false_when_the_payer_was_not_read():
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for ins in ([{"Name": ""}], []):
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data = {"insurance": ins, "cpt": _billed_h()}
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assert bh.detect("C1", data) is False, ins
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@case
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def detect_false_when_the_h_code_has_no_modifier():
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data = {"insurance": BH, "cpt": _cpt(mod1=""),
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"progress_notes": OFFICE_NOTE}
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assert bh.detect("C1", data) is False
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@case
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def detect_false_for_codes_that_only_start_with_h():
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"""Only H0001-H2037 style codes: 'H' plus four digits."""
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for code in ("HCG", "H00231", "H002"):
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data = {"insurance": BH, "cpt": _cpt(code=code),
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"progress_notes": OFFICE_NOTE}
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assert bh.detect("C1", data) is False, code
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@case
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def detect_false_on_a_telehealth_visit():
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data = {"insurance": BH, "cpt": _cpt(), "progress_notes": TELE_NOTE}
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assert bh.detect("C1", data) is False
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@case
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def detect_true_when_the_note_was_not_read():
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"""Unknown telehealth: it fires, and apply() sends it to Review."""
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for note in (None, {"opened": "disabled"}, {"opened": "absent"},
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{"opened": "tab", "error": "boom"}):
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data = {"insurance": BH, "cpt": _cpt()}
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if note is not None:
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data["progress_notes"] = note
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assert bh.detect("C1", data) is True, note
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# ── apply ────────────────────────────────────────────────────────────────────
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@case
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def apply_clears_every_modifier_on_the_h_code_row_only(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page, mods=("GT", "HO", "", ""))
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other_before = [_mods(page, i) for i in (0, 1, 2)]
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result = bh.apply(page, "C1", _data(page))
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assert result.changed is True, result
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assert result.review == "", result.review
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assert result.changes == [{"row": 3, "code": "H0023",
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"before": ["GT", "HO", "", ""],
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"after": ["", "", "", ""], "ok": True}], \
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result.changes
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assert _mods(page, 3) == ["", "", "", ""]
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assert [_mods(page, i) for i in (0, 1, 2)] == other_before, \
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"non-H-code rows must be left exactly as they were"
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row = page.locator(sel.SEL_CPT_ROWS).nth(3)
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assert row.locator(sel.SEL_CPT_MOD1).first.get_attribute("data-blurred") == "1", \
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"M1 must be blurred so eCW's updateCPTMod commits the change"
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@case
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def an_empty_live_grid_declines_instead_of_passing(page):
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"""Review finding 2 (2026-10-12): the grid did not re-render."""
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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data = _data(page)
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page.evaluate("""() => document.querySelectorAll('tr[id^="CPTROW_"]')
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.forEach(tr => tr.remove())""")
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result = bh.apply(page, "C1", data)
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assert result.changed is False
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assert result.review == bh.CPT_GRID_NOT_READ, result.review
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@case
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def a_fee_eCW_reprices_after_the_modifier_change_is_recorded(page):
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"""Review finding 4: eCW re-prices the line on the modifier's blur."""
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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page.evaluate("""() => {
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const tr = document.getElementById('CPTROW_3');
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const fee = tr.querySelector('[data-fieldname="ClaimCPTBilledFee"]');
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tr.querySelector('[data-fieldname="ClaimCPTMOD1"]').addEventListener(
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'blur', () => setTimeout(() => { fee.value = '120.00'; }, 300));
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}""")
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result = bh.apply(page, "C1", _data(page))
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assert result.changes[0]["fee"] == {"before": "150.00",
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"after": "120.00"}, result.changes
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text = bh.describe(result)
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assert "150.00" in text and "120.00" in text, text
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@case
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def a_partial_note_counts_as_not_read_on_a_bh_payer(page):
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"""
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Review, 2026-10-12: a note whose sections never settled may be missing
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the telehealth line, so GT must not be removed on its word.
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"""
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partial = dict(OFFICE_NOTE, partial=True, partial_sections=0)
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assert bh.detect("C1", {"insurance": BH, "cpt": _cpt(),
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"progress_notes": partial}) is True
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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result = bh.apply(page, "C1", _data(page, note=partial))
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assert result.changed is False
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assert result.review == bh.NOTE_NOT_READ, result.review
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assert _mods(page, 3)[0] == "GT"
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@case
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def a_modifier_eCW_puts_back_after_the_blur_is_not_removed(page):
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"""
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The read-back is judged after eCW has had time to react, not straight
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after the blur: here the modifier comes back 300 ms later.
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"""
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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page.evaluate("""() => {
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const m1 = document.getElementById('CPTROW_3')
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.querySelector('[data-fieldname="ClaimCPTMOD1"]');
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m1.addEventListener('blur', () =>
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setTimeout(() => { m1.value = 'GT'; }, 300));
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}""")
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result = bh.apply(page, "C1", _data(page))
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assert result.changes[0]["ok"] is False, result.changes
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assert result.review == bh.NOT_REMOVED, result.review
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assert "STILL SET" in bh.describe(result)
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assert "NOT removed" in bh.summary_comment(result), \
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bh.summary_comment(result)
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@case
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def apply_on_the_ub_form_clears_and_blurs_every_set_modifier(page):
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"""The UB screen's own ids (uBClaimModN), M2 seeded as well as M1."""
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page.goto(UB_FIXTURE.as_uri())
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page.evaluate("""() => {
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const tr = document.querySelectorAll('tr[id^="CPTROW_"]')[0];
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const m2 = tr.querySelector('[id^="uBClaimMod2"]');
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m2.value = 'HO';
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for (const el of tr.querySelectorAll('[id^="uBClaimMod"]'))
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el.addEventListener('blur', () => { el.dataset.blurred = '1'; });
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}""")
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data = _data(page)
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assert data["cpt"][0]["code"] == "H0023"
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result = bh.apply(page, "C1", data)
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assert result.changes and result.changes[0]["before"][:2] == ["GT", "HO"], \
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result.changes
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assert result.changes[0]["ok"] is True
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assert _mods(page, 0) == ["", "", "", ""]
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tr = page.locator(sel.SEL_CPT_ROWS).nth(0)
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for n in (1, 2):
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assert tr.locator(f'[id^="uBClaimMod{n}"]').first \
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.get_attribute("data-blurred") == "1", f"M{n} not blurred"
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@case
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def apply_sends_an_unread_note_to_review_and_changes_nothing(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page, mods=("GT", "", "", ""))
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result = bh.apply(page, "C1", _data(page, note={"opened": "disabled"}))
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assert result.changed is False
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assert result.review == bh.NOTE_NOT_READ, result.review
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assert _mods(page, 3) == ["GT", "", "", ""]
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@case
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def apply_is_a_no_op_when_the_h_code_has_no_modifier(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page, mods=("", "", "", ""))
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result = bh.apply(page, "C1", _data(page))
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assert result.changed is False and result.review == "", result
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@case
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def describe_names_the_code_and_the_removed_modifiers(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page, mods=("GT", "HO", "", ""))
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text = bh.describe(bh.apply(page, "C1", _data(page)))
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assert "H0023" in text and "GT" in text and "HO" in text, text
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@case
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def run_all_on_a_bh_office_visit_fires_this_condition(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page, mods=("GT", "", "", ""))
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report = {}
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results = run_all(page, "C1", _data(page), report=report)
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assert "bh_h_code_modifier" in report["fired"], report
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assert "bh_h_code_modifier" in [r.condition_name for r in results], results
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assert _mods(page, 3) == ["", "", "", ""]
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def _h_row_state(page, index=3):
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row = page.locator(sel.SEL_CPT_ROWS).nth(index)
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return (row.locator(sel.SEL_CPT_ASSIGN_TO_PATIENT).first.is_checked(),
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row.locator(sel.SEL_CPT_BILLED_FEE).first.input_value())
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@case
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def apply_on_a_non_bh_payer_unchecks_and_zeroes_the_h_code_only(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page, mods=("GT", "", "", ""))
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others = [_h_row_state(page, i) for i in (0, 1, 2)]
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result = bh.apply(page, "C1", _data(page, ins=MEDICAID, note=TELE_NOTE))
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assert result.changed is True and result.review == "", result
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assert result.changes == [{"row": 3, "code": "H0023", "unchecked": True,
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"fee": {"before": "150.00",
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"after": "0.00"}}], result.changes
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assert _h_row_state(page) == (False, "0.00")
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assert _mods(page, 3) == ["GT", "", "", ""], "modifier is not this path's"
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assert [_h_row_state(page, i) for i in (0, 1, 2)] == others
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@case
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def apply_on_a_non_bh_payer_with_an_unread_note_still_unchecks(page):
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"""Telehealth does not matter off a BH payer, so the note does not."""
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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result = bh.apply(page, "C1",
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_data(page, ins=MEDICAID, note={"opened": "disabled"}))
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assert result.changed is True, result
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assert _h_row_state(page) == (False, "0.00")
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@case
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def apply_on_a_non_bh_payer_with_an_empty_live_grid_declines(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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data = _data(page, ins=MEDICAID)
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page.evaluate("""() => document.querySelectorAll('tr[id^="CPTROW_"]')
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.forEach(tr => tr.remove())""")
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result = bh.apply(page, "C1", data)
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assert result.changed is False
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assert result.review == bh.CPT_GRID_NOT_READ, result.review
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@case
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def summary_comment_and_describe_follow_the_path_taken(page):
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page.goto(FIXTURE.as_uri())
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_inject_h_row(page)
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off = bh.apply(page, "C1", _data(page, ins=MEDICAID))
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assert bh.summary_comment(off) == ("H code not billed to a non-BH payer "
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"(unchecked and fee zeroed)"), \
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bh.summary_comment(off)
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# UB, no Assign-To-Patient checkbox: only the fee moved (option A).
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fee_only = bh.ConditionResult(
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condition_name=bh.NAME, changed=True,
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changes=[{"row": 0, "code": "H0023",
|
||||
"fee": {"before": "74.00", "after": "0.00"}}])
|
||||
assert bh.summary_comment(fee_only) == ("H code not billed to a non-BH "
|
||||
"payer (fee zeroed)"), \
|
||||
bh.summary_comment(fee_only)
|
||||
text = bh.describe(off)
|
||||
assert "H0023" in text and "150.00" in text and "non-BH" in text, text
|
||||
|
||||
page.goto(FIXTURE.as_uri())
|
||||
_inject_h_row(page)
|
||||
on = bh.apply(page, "C1", _data(page))
|
||||
assert bh.summary_comment(on) == bh.MODIFIER_COMMENT, \
|
||||
bh.summary_comment(on)
|
||||
|
||||
|
||||
@case
|
||||
def run_all_on_a_non_bh_payer_leaves_the_h_code_unchecked_at_zero(page):
|
||||
"""priced_line_check (last) must not re-check it: its fee is 0.00."""
|
||||
page.goto(FIXTURE.as_uri())
|
||||
_inject_h_row(page)
|
||||
report = {}
|
||||
run_all(page, "C1", _data(page, ins=MEDICAID), report=report)
|
||||
assert "bh_h_code_modifier" in report["fired"], report
|
||||
assert _h_row_state(page) == (False, "0.00")
|
||||
|
||||
|
||||
@case
|
||||
def run_all_on_a_bh_telehealth_visit_keeps_gt(page):
|
||||
page.goto(FIXTURE.as_uri())
|
||||
_inject_h_row(page, mods=("GT", "", "", ""))
|
||||
report = {}
|
||||
run_all(page, "C1", _data(page, note=TELE_NOTE), report=report)
|
||||
assert "bh_h_code_modifier" not in report["fired"], report
|
||||
assert _mods(page, 3)[0] == "GT"
|
||||
|
||||
|
||||
def main() -> int:
|
||||
if not FIXTURE.exists():
|
||||
print(f" FAIL fixture missing: {FIXTURE}")
|
||||
return 1
|
||||
try:
|
||||
from playwright.sync_api import sync_playwright
|
||||
except ImportError:
|
||||
print(" SKIP playwright is not installed")
|
||||
return 0
|
||||
|
||||
failures = 0
|
||||
with sync_playwright() as pw:
|
||||
browser = pw.chromium.launch(headless=True)
|
||||
page = browser.new_page()
|
||||
|
||||
for fn in CASES:
|
||||
name = fn.__name__.replace("_", " ")
|
||||
try:
|
||||
if len(inspect.signature(fn).parameters) == 0:
|
||||
fn()
|
||||
else:
|
||||
fn(page)
|
||||
print(f" ok {name}")
|
||||
except AssertionError as exc:
|
||||
print(f" FAIL {name}: {exc}")
|
||||
failures += 1
|
||||
except Exception as exc:
|
||||
print(f" ERROR {name}: {type(exc).__name__}: {exc}")
|
||||
failures += 1
|
||||
browser.close()
|
||||
|
||||
print(f"\n{len(CASES) - failures}/{len(CASES)} passed")
|
||||
return 1 if failures else 0
|
||||
|
||||
|
||||
if __name__ == "__main__":
|
||||
sys.exit(main())
|
||||
Reference in new issue
Block a user