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Reference-data normalization

Source mapping

Source family Preferred input Parser Canonical output Effective-date semantics
ICD-10-CM Official tabular XML ZIP XML hierarchy adapter code_entries + code_search_documents Source release date; official hierarchy and leaf status preserved
ICD-10-PCS Official order-file ZIP Fixed-width order adapter code_entries with system ICD10PCS Stored for future compatibility; not active for V1 coding
HCPCS Level II CMS Alpha-Numeric ZIP Fixed-width contractor record code_entries, modifier_entries Source release effective date; numeric Level I rows excluded from the public HCPCS import
PFS/RVU CMS CSV inside release ZIP Header-driven CSV adapter pfs_procedure_attributes Release effective date; CPT/HCPCS identifiers preserved as strings
NCCI PTP CMS practitioner/hospital XLSX or CSV ZIPs Header-driven tabular adapter ncci_ptp_edits Directional Column 1/Column 2 records; setting is mandatory
MUE CMS practitioner/facility XLSX ZIPs Minimal OpenXML adapter mue_edits Setting is mandatory; disclosed values only
Add-on codes CMS AOC XLSX ZIP Minimal OpenXML adapter addon_code_relations Effective/deletion Julian dates are converted without inventing ranges
Policy manuals Versioned official PDFs Metadata/checksum adapter rule_source_documents Document release date; narrative is not converted into hard rules automatically
CPT AMA CPT Standard current-format annual package Tab-delimited licensed boundary adapter code_entries, code_search_documents, modifier_entries Annual codes use the code-set effective year; descriptor-effective dates remain metadata and are not misrepresented as code-effective dates

Canonical rules

Codes remain strings. Display punctuation is preserved while code_key is uppercased and stripped of non-alphanumeric formatting. Leading zeroes are retained. Every row links to a release and a raw source record. Missing values remain missing; parsers do not synthesize descriptions, dates, flags, or relationships.

Validation and publication

Validation checks required sources, AMA annual control totals, checksums, blank and duplicate keys, effective-date order, MUE values, NCCI directionality/indicator values, source links, and cross-source references. Historical NCCI revisions receive a deterministic revision key so valid intervals are preserved without collapsing distinct records. References to inactive, deleted, or later-quarter codes remain advisory. Missing CPT or NCCI PTP data is blocking. Publication is a separate transaction and only accepts a validated release.

Known limitations

  • The supplied bundle contains extracted practitioner and hospital NCCI PTP data; the adapter streams these multi-million-row files in bounded batches.
  • Licensed CPT source artifacts must remain outside Git, Docker images, frontend assets, logs, and API source-file responses.
  • Narrative NCCI policy PDFs are inventoried but not transformed into deterministic rules.
  • Embeddings are deferred until a canonical release can be published; lexical search documents are generated now.