Pertinência de medicamentos

Overview

Implements the rule for detecting inappropriate use of neuromuscular blocker reversal medications. This class is responsible for identifying cases where Sugamadex sodium (neuromuscular blocker reversal medication) is billed but not clinically justified based on the anesthetic procedure level. The rule evaluates whether the procedure complexity warrants the use of such medications according to clinical criteria.

Architecture

Field	Value
Name	Pertinência de medicamentos
Agent ID	C058
Version	1
Nature	tech
Layer	—

Inheritance

NeuromuscularBlockerReversalRule → BaseRule → BaseAgent

Core Functionality

1. load_artifacts
2. prepare_data
3. rule_assessment

Business Rules

Pertinência de medicamentos

Consultar código-fonte para regras de negócio detalhadas.

Usage

from agents.neuromuscularblockerreversalrule import NeuromuscularBlockerReversalRule

rule = NeuromuscularBlockerReversalRule()
violations_df = rule.rule_assessment(claims_df)

Configuration

rule = NeuromuscularBlockerReversalRule(
    th_proced_level=1,
    logger=logger,
    evaluated=False) -> None:,
)

Input Requirements

Column	Type	Description
ARVO_COLUMNS.code_type	-	-
EVENT_COLUMNS.id_evento	-	-
ARVO_COLUMNS.code_type_predicted	-	-
ARVO_COLUMNS.id_evento_predicted	-	-
EVENT_COLUMNS.evento	-	-
EVENT_COLUMNS.vl_pago	-	-
EVENT_COLUMNS.id_fatura	-	-
EVENT_COLUMNS.id	-	-
EVENT_COLUMNS.qt_paga	-	-
ARVO_COLUMNS.proced_cir_inv_agg	-	-
ARVO_COLUMNS.tempo_internacao_uti	-	-

Output Format

Glosa DataFrame Columns

Column	Description
agent_id	C058
version	1
id_arvo	Original record ID
vl_glosa_arvo	Glosa value
qt_glosa_arvo	Glosa quantity
score_arvo	Confidence score
motivo_glosa_arvo	Detailed reason in Portuguese
motivo_glosa_ANS	ANS standard code
data_dict	JSON metadata with calculation details

Error Handling

• DataFrames vazios retornam estrutura vazia com colunas obrigatórias.
• Colunas ausentes geram warning mas não causam crash.
• Conversões numéricas usam errors="coerce" para evitar falhas.