Alex/otr 1588 switch cpt search to use oystehr terminology service

README.md

@@ -137,14 +137,6 @@ npm run ehr:e2e:local:ui
 
 Full E2E Documentation: [E2E_README.md](./E2E_README.md)
 
-## Setting up Terminology Search
-
-<!-- cSpell:disable-next umls -->
-
-Ottehr uses UMLS Terminology Services for searching for ICD-10 and CPT codes.
-
-To set up the terminology search service, please follow these instructions in the [Oystehr docs](https://docs.oystehr.com/oystehr/services/zambda/examples/terminology-search/#1-get-a-national-library-of-medicine-api-key), and then save the API key as `NLM_API_KEY` in the Zambdas secrets.
-
 ## Repository Structure
 
 This repository uses a monorepo structure.

apps/ehr/src/components/input/SingleCptInput.tsx

@@ -1,7 +1,7 @@
 import { useState } from 'react';
-import { useGetIcd10Search } from 'src/features/visits/shared/stores/appointment/appointment.queries';
 import { useDebounce } from 'src/shared/hooks/useDebounce';
 import { CPTCodeDTO } from 'utils';
+import { useGetCPTHCPCSSearch } from '../../features/visits/shared/stores/appointment/appointment.queries';
 import { AutocompleteInput } from './AutocompleteInput';
 
 type Props = {
@@ -13,7 +13,7 @@ type Props = {
 
 export const SingleCptCodeInput: React.FC<Props> = ({ name, label, required, dataTestId }) => {
   const [debouncedSearchTerm, setDebouncedSearchTerm] = useState('');
-  const { isFetching, data } = useGetIcd10Search({ search: debouncedSearchTerm, sabs: 'CPT' });
+  const { isFetching, data } = useGetCPTHCPCSSearch({ search: debouncedSearchTerm, type: 'both' });
   const options = ((data as { codes?: CPTCodeDTO[] })?.codes || []).map((cptCodeDto) => {
     return {
       label: `${cptCodeDto.code} ${cptCodeDto.display}`,

apps/ehr/src/features/radiology/pages/CreateRadiologyOrder.tsx

@@ -17,7 +17,7 @@ import { useNavigate } from 'react-router-dom';
 import { dataTestIds } from 'src/constants/data-test-ids';
 import { getRadiologyUrl } from 'src/features/visits/in-person/routing/helpers';
 import {
-  useGetIcd10Search,
+  useGetCPTHCPCSSearch,
   useICD10SearchNew,
 } from 'src/features/visits/shared/stores/appointment/appointment.queries';
 import {
@@ -66,9 +66,9 @@ export const CreateRadiologyOrder: React.FC<CreateRadiologyOrdersProps> = () =>
 
   // used to fetch cpt codes
   const [cptDebouncedSearchTerm, setCptDebouncedSearchTerm] = useState('');
-  const { isFetching: isSearchingCpt, data: cptData } = useGetIcd10Search({
+  const { isFetching: isSearchingCpt, data: cptData } = useGetCPTHCPCSSearch({
     search: cptDebouncedSearchTerm,
-    sabs: 'CPT',
+    type: 'cpt',
     radiologyOnly: true, // Only fetch CPT codes related to radiology
   });
   const cptSearchOptions = cptData?.codes || radiologyStudiesConfig;

apps/ehr/src/features/visits/in-person/pages/ProceduresNew.tsx

@@ -56,7 +56,7 @@ import {
 import { DiagnosesField } from '../../shared/components/assessment-tab/DiagnosesField';
 import { PageTitle } from '../../shared/components/PageTitle';
 import { useGetAppointmentAccessibility } from '../../shared/hooks/useGetAppointmentAccessibility';
-import { useGetIcd10Search, useRecommendBillingCodes } from '../../shared/stores/appointment/appointment.queries';
+import { useGetCPTHCPCSSearch, useRecommendBillingCodes } from '../../shared/stores/appointment/appointment.queries';
 import { useChartData, useDeleteChartData, useSaveChartData } from '../../shared/stores/appointment/appointment.store';
 import { useAppFlags } from '../../shared/stores/contexts/useAppFlags';
 import AiSuggestion from '../components/AiSuggestion';
@@ -401,7 +401,7 @@ export default function ProceduresNew(): ReactElement {
   };
 
   const [debouncedSearchTerm, setDebouncedSearchTerm] = useState('');
-  const { isFetching: isSearching, data } = useGetIcd10Search({ search: debouncedSearchTerm, sabs: 'CPT' });
+  const { isFetching: isSearching, data } = useGetCPTHCPCSSearch({ search: debouncedSearchTerm, type: 'both' });
   const cptSearchOptions = (data as { codes?: CPTCodeDTO[] })?.codes || [];
   const { debounce } = useDebounce(800);
   const debouncedHandleInputChange = (data: string): void => {

apps/ehr/src/features/visits/shared/api/oystehrApi.ts

@@ -24,8 +24,6 @@ import {
   GetTelemedAppointmentsResponseEhr,
   GetUnsolicitedResultsResourcesInput,
   GetUnsolicitedResultsResourcesOutput,
-  IcdSearchRequestParams,
-  IcdSearchResponse,
   InitTelemedSessionRequestParams,
   InitTelemedSessionResponse,
   LabOrderResourcesRes,
@@ -138,7 +136,6 @@ export const getOystehrTelemedAPI = (
   getPatientInstructions: typeof getPatientInstructions;
   savePatientInstruction: typeof savePatientInstruction;
   deletePatientInstruction: typeof deletePatientInstruction;
-  icdSearch: typeof icdSearch;
   recommendBillingSuggestions: typeof recommendBillingSuggestions;
   recommendBillingCodes: typeof recommendBillingCodes;
   createUpdateMedicationOrder: typeof createUpdateMedicationOrder;
@@ -302,10 +299,6 @@ export const getOystehrTelemedAPI = (
     return await makeZapRequest('create update patient followup', parameters);
   };
 
-  const icdSearch = async (parameters: IcdSearchRequestParams): Promise<IcdSearchResponse> => {
-    return await makeZapRequest('icd search', parameters);
-  };
-
   const recommendBillingSuggestions = async (parameters: {
     diagnoses: DiagnosisDTO[] | undefined;
     billing: CPTCodeDTO[] | undefined;
@@ -394,7 +387,6 @@ export const getOystehrTelemedAPI = (
     getPatientInstructions,
     savePatientInstruction,
     deletePatientInstruction,
-    icdSearch,
     recommendBillingSuggestions,
     recommendBillingCodes,
     getMedicationOrders,

apps/ehr/src/features/visits/shared/components/assessment-tab/BillingCodesContainer.tsx

@@ -10,7 +10,7 @@
 import { useDebounce } from 'src/shared/hooks/useDebounce';
 import { APIErrorCode, CPTCodeOption, emCodeOptions } from 'utils';
 import { useGetAppointmentAccessibility } from '../../hooks/useGetAppointmentAccessibility';
-import { useGetIcd10Search } from '../../stores/appointment/appointment.queries';
+import { useGetCPTHCPCSSearch } from '../../stores/appointment/appointment.queries';
 import { useChartData, useDeleteChartData, useSaveChartData } from '../../stores/appointment/appointment.store';
 
 export const BillingCodesContainer: FC = () => {
@@ -24,7 +24,7 @@
     isFetching: isSearching,
     data,
     error: icdSearchError,
-  } = useGetIcd10Search({ search: debouncedSearchTerm, sabs: 'CPT' });
+  } = useGetCPTHCPCSSearch({ search: debouncedSearchTerm, type: 'both' });
   const cptSearchOptions = data?.codes || [];
 
   const { mutate: saveEMChartData, isPending: isSaveEMLoading } = useSaveChartData();

apps/ehr/src/features/visits/shared/hooks/useOystehrAPIClient.ts

@@ -26,7 +26,6 @@ export const useOystehrAPIClient = (): ReturnType<typeof getOystehrTelemedAPI> |
           deletePatientInstructionZambdaID: 'delete-patient-instruction',
           createUpdateMedicationOrderZambdaID: 'create-update-medication-order',
           getMedicationOrdersZambdaID: 'get-medication-orders',
-          icdSearchZambdaId: 'icd-search',
           recommendBillingSuggestionsZambdaID: 'recommend-billing-suggestions',
           recommendBillingCodesZambdaID: 'recommend-billing-codes',
           isAppLocal: import.meta.env.VITE_APP_IS_LOCAL,

apps/ehr/src/features/visits/shared/stores/appointment/appointment.queries.ts

@@ -27,9 +27,9 @@ import { useApiClients } from 'src/hooks/useAppClients';
 import useEvolveUser from 'src/hooks/useEvolveUser';
 import {
   APIError,
-  APIErrorCode,
   CancelMatchUnsolicitedResultTask,
   CPTCodeDTO,
+  CPTSearchRequestParams,
   createSmsModel,
   DiagnosisDTO,
   filterResources,
@@ -51,7 +51,6 @@ import {
   GetUnsolicitedResultsTasksOutput,
   Icd10SearchRequestParams,
   Icd10SearchResponse,
-  IcdSearchRequestParams,
   IcdSearchResponse,
   InstructionType,
   INVENTORY_MEDICATION_TYPE_CODE,
@@ -512,33 +511,75 @@ export function useFinalizeUnsolicitedResultMatch(): UseMutationResult<void, Err
   });
 }
 
-export const useGetIcd10Search = ({
+export const useGetCPTHCPCSSearch = ({
   search,
-  sabs,
+  type,
   radiologyOnly,
-}: IcdSearchRequestParams): UseQueryResult<IcdSearchResponse | undefined, APIError> => {
-  const apiClient = useOystehrAPIClient();
+}: CPTSearchRequestParams): UseQueryResult<IcdSearchResponse | undefined, APIError> => {
+  const { oystehr } = useApiClients();
 
   const queryResult = useQuery({
-    queryKey: ['icd-search', search, sabs, radiologyOnly],
+    queryKey: ['hcpcs-search', search, radiologyOnly],
 
     queryFn: async () => {
-      return apiClient?.icdSearch({ search, sabs, radiologyOnly });
+      switch (type) {
+        case 'cpt': {
+          const terminologyResponse = await oystehr?.terminology.searchCpt({
+            query: search,
+            searchType: 'all',
+            limit: 100,
+          });
+          if (!terminologyResponse) {
+            throw new Error('could not get terminology results');
+          }
+          if (radiologyOnly) {
+            terminologyResponse.codes = terminologyResponse!.codes.filter((code) => code.code.startsWith('7'));
+          }
+          terminologyResponse.codes = terminologyResponse.codes.sort((a, b) => a.code.localeCompare(b.code));
+          return terminologyResponse;
+        }
+        case 'hcpcs': {
+          const terminologyResponse = await oystehr?.terminology.searchHcpcs({
+            query: search,
+            searchType: 'all',
+            limit: 100,
+          });
+          if (!terminologyResponse) {
+            throw new Error('could not get terminology results');
+          }
+          terminologyResponse.codes = terminologyResponse.codes.sort((a, b) => a.code.localeCompare(b.code));
+          return terminologyResponse;
+        }
+        case 'both': {
+          const [cptResponse, hcpcsResponse] = await Promise.all([
+            oystehr?.terminology.searchCpt({
+              query: search,
+              searchType: 'all',
+              limit: 100,
+            }),
+            oystehr?.terminology.searchHcpcs({
+              query: search,
+              searchType: 'all',
+              limit: 100,
+            }),
+          ]);
+          if (!cptResponse || !hcpcsResponse) {
+            throw new Error('could not get terminology results');
+          }
+          let combinedCodes = [...cptResponse.codes, ...hcpcsResponse.codes].filter(
+            (codeValues, index, self) => index === self.findIndex((t) => t.code === codeValues.code)
+          );
+          combinedCodes = combinedCodes.sort((a, b) => a.code.localeCompare(b.code));
+          return { codes: combinedCodes };
+        }
+      }
     },
 
-    enabled: Boolean(apiClient && search),
+    enabled: Boolean(oystehr && search),
     placeholderData: keepPreviousData,
     staleTime: QUERY_STALE_TIME,
   });
 
-  useEffect(() => {
-    if (queryResult.error && (queryResult.error as APIError)?.code !== APIErrorCode.MISSING_NLM_API_KEY_ERROR) {
-      enqueueSnackbar('An error occurred during the search. Please try again in a moment.', {
-        variant: 'error',
-      });
-    }
-  }, [queryResult.error]);
-
   return queryResult;
 };
 

config/oystehr/roles.json

@@ -166,6 +166,11 @@
           "resource": ["Zambda:Function:*"],
           "action": ["Zambda:InvokeFunction"],
           "effect": "Allow"
+        },
+        {
+          "resource": ["Terminology:Code:*"],
+          "action": ["Terminology:SearchCodes"],
+          "effect": "Allow"
         }
       ]
     },
@@ -332,6 +337,11 @@
             "FHIR:Patient",
             "FHIR:RelatedPerson"
           ]
+        },
+        {
+          "resource": ["Terminology:Code:*"],
+          "action": ["Terminology:SearchCodes"],
+          "effect": "Allow"
         }
       ]
     },
@@ -443,6 +453,11 @@
           "action": ["eRx:SearchMedication"],
           "resource": ["eRx:Medication"],
           "effect": "Allow"
+        },
+        {
+          "resource": ["Terminology:Code:*"],
+          "action": ["Terminology:SearchCodes"],
+          "effect": "Allow"
         }
       ]
     },
@@ -512,6 +527,11 @@
           "action": ["FHIR:History"],
           "effect": "Allow",
           "resource": ["FHIR:Patient", "FHIR:Appointment"]
+        },
+        {
+          "resource": ["Terminology:Code:*"],
+          "action": ["Terminology:SearchCodes"],
+          "effect": "Allow"
         }
       ]
     },
@@ -621,6 +641,11 @@
             "FHIR:Patient",
             "FHIR:RelatedPerson"
           ]
+        },
+        {
+          "resource": ["Terminology:Code:*"],
+          "action": ["Terminology:SearchCodes"],
+          "effect": "Allow"
         }
       ]
     },

config/oystehr/zambdas.json

@@ -218,13 +218,6 @@
       "src": "src/ehr/sync-user/index",
       "zip": ".dist/zips/sync-user.zip"
     },
-    "ICD-SEARCH": {
-      "name": "icd-search",
-      "type": "http_auth",
-      "runtime": "nodejs22.x",
-      "src": "src/ehr/icd-search/index",
-      "zip": ".dist/zips/icd-search.zip"
-    },
     "ICD-10-SEARCH": {
       "name": "icd-10-search",
       "type": "http_auth",

package.json

@@ -109,7 +109,7 @@
     "@mui/material": "^5.14.18",
     "@mui/system": "^5.10.16",
     "@mui/x-date-pickers": "^6.18.6",
-    "@oystehr/sdk": "4.1.8",
+    "@oystehr/sdk": "4.2.4",
     "@pdf-lib/fontkit": "^1.1.1",
     "@sendgrid/mail": "^8.1.6",
     "@sentry/aws-serverless": "^8.26.0",

packages/utils/lib/types/api/icd-search/icd-search.types.ts

@@ -1,8 +1,8 @@
 import { Coding } from 'fhir/r4b';
 
-export interface IcdSearchRequestParams {
+export interface CPTSearchRequestParams {
   search: string;
-  sabs: 'ICD10CM' | 'CPT';
+  type: 'cpt' | 'hcpcs' | 'both';
   radiologyOnly?: boolean;
 }