solventum/json-schema/solventum-coding-result-schema.json at main · api-evangelist/solventum · GitHub

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{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/solventum/main/json-schema/solventum-coding-result-schema.json",
  "title": "CodingResult",
  "description": "The output of Solventum's computer-assisted coding (CAC) engine, including suggested ICD-10 codes, DRG assignment, and quality flags.",
  "type": "object",
  "properties": {
    "encounterId": {
      "type": "string",
      "description": "Reference to the source encounter"
    },
    "processingTimestamp": {
      "type": "string",
      "format": "date-time",
      "description": "When coding was performed"
    },
    "codeSetVersion": {
      "type": "string",
      "description": "ICD-10 code set version used (e.g., FY2026)"
    },
    "suggestedDiagnoses": {
      "type": "array",
      "description": "AI-suggested diagnosis codes with confidence scores",
      "items": {
        "type": "object",
        "properties": {
          "code": { "type": "string", "description": "ICD-10-CM code" },
          "description": { "type": "string", "description": "Code description" },
          "type": { "type": "string", "enum": ["principal", "secondary", "admitting", "external-cause"] },
          "confidence": { "type": "number", "minimum": 0, "maximum": 1, "description": "AI confidence score" },
          "evidenceText": { "type": "string", "description": "Supporting text from clinical notes" },
          "status": { "type": "string", "enum": ["suggested", "accepted", "rejected", "modified"], "description": "Coder review status" }
        }
      }
    },
    "suggestedProcedures": {
      "type": "array",
      "description": "AI-suggested procedure codes with confidence scores",
      "items": {
        "type": "object",
        "properties": {
          "code": { "type": "string", "description": "ICD-10-PCS or CPT code" },
          "description": { "type": "string" },
          "confidence": { "type": "number", "minimum": 0, "maximum": 1 },
          "evidenceText": { "type": "string" },
          "status": { "type": "string", "enum": ["suggested", "accepted", "rejected", "modified"] }
        }
      }
    },
    "drgAssignment": {
      "type": "object",
      "description": "Diagnosis-Related Group assignment result",
      "properties": {
        "msdrg": { "type": "string", "description": "Medicare Severity DRG code" },
        "msdrgDescription": { "type": "string", "description": "MS-DRG description" },
        "mdc": { "type": "string", "description": "Major Diagnostic Category" },
        "severity": { "type": "string", "enum": ["1", "2", "3", "4"], "description": "Severity of illness (1=minor, 4=extreme)" },
        "mortalityRisk": { "type": "string", "enum": ["1", "2", "3", "4"], "description": "Risk of mortality score" },
        "geometricMeanLos": { "type": "number", "description": "Expected geometric mean length of stay" },
        "relativeWeight": { "type": "number", "description": "MS-DRG relative weight for reimbursement" }
      }
    },
    "qualityFlags": {
      "type": "array",
      "description": "Documentation quality and compliance alerts",
      "items": {
        "type": "object",
        "properties": {
          "flagType": { "type": "string", "description": "Type of quality flag" },
          "severity": { "type": "string", "enum": ["info", "warning", "error"] },
          "message": { "type": "string", "description": "Flag description" }
        }
      }
    }
  },
  "required": ["encounterId", "processingTimestamp"]
}