Initial commit
This commit is contained in:
84
config/rules/aggressive_rules.yaml
Normal file
84
config/rules/aggressive_rules.yaml
Normal file
@@ -0,0 +1,84 @@
|
||||
# Règles de codage PMSI - Mode agressif
|
||||
# Version: 1.0.0
|
||||
|
||||
version: "1.0.0"
|
||||
name: "Règles de codage PMSI - Mode agressif"
|
||||
description: "Jeu de règles avec mode agressif pour maximiser le codage"
|
||||
mode: "agressif"
|
||||
|
||||
rules:
|
||||
# Règles DP - Mode agressif
|
||||
- rule_id: "dp_001"
|
||||
name: "DP obligatoire"
|
||||
description: "Un diagnostic principal doit toujours être présent"
|
||||
category: "dp"
|
||||
condition:
|
||||
type: "required"
|
||||
action: "reject_if_missing"
|
||||
severity: "bloquant"
|
||||
enabled: true
|
||||
|
||||
- rule_id: "dp_002_agg"
|
||||
name: "DP avec confiance minimale réduite"
|
||||
description: "Le DP peut avoir un score de confiance >= 0.5 en mode agressif"
|
||||
category: "dp"
|
||||
condition:
|
||||
min_confidence: 0.5
|
||||
action: "flag_for_review"
|
||||
severity: "info"
|
||||
enabled: true
|
||||
|
||||
# Règles DAS - Mode agressif
|
||||
- rule_id: "das_001_agg"
|
||||
name: "DAS avec preuves assouplies"
|
||||
description: "Les DAS peuvent être proposés avec preuves indirectes"
|
||||
category: "das"
|
||||
condition:
|
||||
min_evidence: 1
|
||||
allow_indirect: true
|
||||
action: "flag_for_review"
|
||||
severity: "info"
|
||||
enabled: true
|
||||
|
||||
- rule_id: "das_002"
|
||||
name: "Limite de DAS étendue"
|
||||
description: "Maximum 30 DAS par séjour en mode agressif"
|
||||
category: "das"
|
||||
condition:
|
||||
max_count: 30
|
||||
action: "reject_excess"
|
||||
severity: "bloquant"
|
||||
enabled: true
|
||||
|
||||
# Règles CCAM
|
||||
- rule_id: "ccam_001"
|
||||
name: "Date CCAM obligatoire"
|
||||
description: "Chaque acte CCAM doit avoir une date de réalisation"
|
||||
category: "ccam"
|
||||
condition:
|
||||
type: "required_date"
|
||||
action: "reject_if_missing"
|
||||
severity: "bloquant"
|
||||
enabled: true
|
||||
|
||||
# Règles de validation - Mode agressif
|
||||
- rule_id: "neg_001"
|
||||
name: "Pas de codes pour faits niés"
|
||||
description: "Les faits cliniques niés ne doivent jamais être codés"
|
||||
category: "validation"
|
||||
condition:
|
||||
qualifier: "nié"
|
||||
action: "reject_code"
|
||||
severity: "bloquant"
|
||||
enabled: true
|
||||
|
||||
- rule_id: "susp_001_agg"
|
||||
name: "DAS possibles pour faits suspectés"
|
||||
description: "Les faits suspectés peuvent être codés comme DAS en mode agressif"
|
||||
category: "validation"
|
||||
condition:
|
||||
qualifier: "suspecté"
|
||||
code_type: "das"
|
||||
action: "allow_with_flag"
|
||||
severity: "info"
|
||||
enabled: true
|
||||
Reference in New Issue
Block a user