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Changelog

All notable changes to Myelin will be documented in this file.

The format is based on Keep a Changelog, and this project adheres to Semantic Versioning.

[1.0.0] - 2026-07-10

First stable release of Myelin. Provides a unified Python interface to the official CMS (Centers for Medicare & Medicaid Services) Java-based reimbursement tools via JPype1.

Added

  • MS-DRG Grouper (DrgClient) - assigns inpatient claims to DRGs for IPPS, IPF, and LTCH payment determination.
  • MCE Editor (MceClient) - validates inpatient claims against the Medicare Code Editor.
  • IOCE Editor (IoceClient) - processes outpatient claims through the Integrated Outpatient Code Editor, assigning APCs and applying edits.
  • HHA Grouper (HhagClient) - groups home health claims using OASIS assessment data.
  • IRF Grouper (IrfgClient) - groups inpatient rehabilitation facility claims into Case-Mix Groups (CMGs) using IRF-PAI data.
  • Pricer suite for IPPS, OPPS, IPF (Psych), IRF, LTCH, SNF, HHA, Hospice, ESRD, and FQHC.
  • ASC Pricer - pure-Python Ambulatory Surgical Center pricer with support for code-pair offsets, MUE limits, device discounts, and wage index lookup.
  • Myelin orchestrator with a process(claim) entry point that wires the correct grouper, editor, and pricer together.
  • AUTO module - automatic detection of required modules based on bill type, revenue codes, and provider data.
  • IPSF / OPSF provider data - automatic lookup from CMS provider-specific files with per-claim override support for what-if analysis.
  • ICD-10 code conversion (ICDConverter) - forward/backward mapping of diagnosis and procedure codes between fiscal years.
  • UB-04 (CMS-1450) PDF read/write - generate a filled UB-04 PDF from a Claim and parse a filled UB-04 PDF back into a Claim object, plus a calibration PDF helper for verifying field mappings.
  • Excel export - MyelinOutput.to_excel() and to_excel_bytes() for producing human-readable summaries of pricing/editing decisions.
  • Pydantic input/output models throughout for type-safe claim construction and result handling.
  • Plugin system via pluggy (client_load_classes, client_methods hookspecs) for custom Java class loading and client method extension.
  • CMSDownloader - async, robust downloader for CMS grouper, editor, and pricer JARs with version tracking and extraction.
  • SQLite and PostgreSQL database backends for provider data and ICD-10 conversion tables.
  • JVM lifecycle management - thread-safe startup/shutdown, context-manager support (with Myelin(...) as m:), and clean integration with multi-process workloads.
  • Java stub generation (create_stubs.py) for IDE type checking of JPype interop. This effort was abandoned, may revisit in the future.
  • New IOCE fields added
    • IoceOutputHcpcsModifier.description — for modifier descriptions on both input and output modifier lists
    • IoceOutputLineItem: action_flag_output_description, rejection_denial_flag_description, payment_method_flag_description, payment_indicator_description, revenue_code_description, discounting_formula_description
    • IoceOutput: claim_rejection_edit_disposition_description, claim_denial_edit_disposition_description, claim_return_to_provider_edit_disposition_description, claim_suspension_edit_disposition_description, line_rejection_edit_disposition_description, line_denial_edit_disposition_description
  • New descriptions added to ICOE output
    • _enrich_disposition_and_edits now calls getEditDispositionDescription per disposition group when edits are present
    • Line items now also call: getLineItemActionFlagDescription, getLineItemDenialRejectionFlagDescription, getPaymentMethodFlagDescription, getPaymentIndicatorDescription, getRevenueCodeDescription, getDiscountFormulaDescription
    • Both input and output HCPCS modifier lists now call getHcpcsModifierDescription per modifier in addition to the existing edit descriptions
  • Provider data patching - IPSFDatabase.patch() and OPSFDatabase.patch() methods for incremental updates to provider-specific data. Queries the maximum last_updated date, downloads only new records from that point forward, and upserts them (updating existing records with the same provider_ccn + effective_date, inserting new ones). Supports both YYYYMMDD and YYYY-MM-DD date formats.
  • MS-DRG diagnosis output codes - MsdrgOutputDxCode now includes the original diagnosis code value, making principal and secondary diagnosis outputs easier to trace back to claim input.
  • IOCE description enrichment - IOCE output now fills additional claim disposition, edit, line-item flag, modifier, payment indicator, revenue code, discount formula, and APC descriptions, with latest-description fallbacks when version-specific lookup text is unavailable.
  • IRF wage-index outputs - IrfOutput now exposes inherited final CBSA and final wage-index values from the CMS payment data.

Changed

  • Centralized IPSF / OPSF provider lookups and exposed them on MyelinOutput alongside pricer results.
  • Refactored Myelin.process() to make provider lookup errors non-halting and standardize error returns to ReturnCode values.
  • Improved type safety across the library with Protocol types for Java interop surfaces.
  • LTCH pricer now accepts an optional review code via claim additional_data and defaults the blend indicator to 0 when not provided.
  • OPPS pricer tolerates a missing discount formula from IOCE.
  • Hospice pricer tolerates a missing admit date and an optional IOCE output pass-through.
  • IPSF / OPSF data is whitespace-stripped before being passed to Java pricers.
  • Default county_code is now 0 instead of an empty string.
  • Excel exporter strips nested-structure prefixes from column names and can optionally include the input claim on its own sheet.
  • ASC Pricer no longer requires an OPSF provider (ASCs do not appear in OPSF).
  • MCE input construction validates the discharge status.
  • CMSDownloader - rewritten for clearer component discovery, jar inventory validation, missing-jar detection, bounded concurrent pricer downloads, shared request timeout handling, and cleaner extraction of only the required CMS runtime jars.

Fixed

  • Duplicate IRFG client initialization and duplicate ASC client setup in Myelin removed.
  • Duplicate IPSF definition in core.py removed.
  • LTCH-specific updates now applied prior to the Java call.
  • HHA claim input construction.
  • ICD converter no longer raises on a None check.
  • Minor formatting issue on the Excel exporter summary tab.
  • IoceReturnCode renamed from ReturnCode to avoid duplicate naming with the shared utility.
  • IPPS procedure codes - inpatient procedure codes are now passed to the IPPS Java claim object as Java strings and assigned with setProcedureCodes.
  • IPSF HRR participant indicator - preserves 0 values instead of treating them as missing, preventing invalid return codes and incorrect pricing.
  • Supplemental wage index mapping - LTCH, SNF, and IRF now opt in to sending IPSF supplemental wage-index fields to the CMS Java provider object while IPF and other shared IPSF call sites keep the previous default behavior.