From ee8314f574052665e543176385276fdd45a8476d Mon Sep 17 00:00:00 2001 From: Mayank Aamseek Date: Mon, 3 Nov 2025 16:11:44 +0000 Subject: [PATCH] Merged in bugfix/Moline-NV-carveout-cd (pull request #758) handle multiple default_terms in one reimb_term * handle multiple default_terms in one reimb_term Approved-by: Katon Minhas --- fieldExtraction/constants/mappings/valid_carveouts.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/fieldExtraction/constants/mappings/valid_carveouts.json b/fieldExtraction/constants/mappings/valid_carveouts.json index 6e8c272..1ac7dec 100644 --- a/fieldExtraction/constants/mappings/valid_carveouts.json +++ b/fieldExtraction/constants/mappings/valid_carveouts.json @@ -17,6 +17,6 @@ "PROFESSIONAL_COMPONENT": "If Modifier 26 (professional component) is present.", "DIAGNOSTIC_PROCEDURES": "Describes payments for diagnostic procedures.", "READMISSIONS": "Describes payment for subsequent admission with the same diagnostic category of codes as the initial admission.", - "DEFAULT_TERM": "Indicates whether this service/methodology serves as a default/fallback payment rate when no other payment methods mentioned anywhere in the contract apply. The default/fallback/'end-of-the-line' payment rate may be a lower rate, often based on billed charges. It may be specific to certain services or applicable to all services. Do not classify as default if:\n- The methodology is the primary/base reimbursement approach, even if defined by exclusion\n- No default/fallback language is present\n\nExamples: \n- 'For any services not specifically listed in Exhibits A-D, reimbursement shall be 50% of billed charges.' \n- 'If there is no payment rate under the Medicare Fee Schedule, [alternative rate applies].'" + "DEFAULT_TERM": "Indicates whether this service/methodology serves as a default/fallback payment rate when other payment method does not apply. The default/fallback payment rate may be a lower rate. It may be specific to certain services or applicable to all services. Do not classify as default if:\n- The methodology is the primary/base reimbursement approach, even if defined by exclusion\n- No default/fallback language is present\n\nExamples: \n- 'For any services not specifically listed in Exhibits A-D, reimbursement shall be 50% of billed charges.' \n- 'If there is no payment rate under the Medicare Fee Schedule, alternative rate e.g. Medicare Rate applies.'" } } \ No newline at end of file