Merged in bugfix/carveout_cd (pull request #811)

bugfix/carveout_cd to main

* added age constraint for payment carveout

* Merged main into bugfix/carveout_cd


Approved-by: Katon Minhas

fieldExtraction/constants/mappings/valid_carveouts.json

@@ -4,7 +4,7 @@
     },
     "mapping": {
         "BASE_COVERED_SERVICES": "Base reimbursement rates that form the foundation of the payment structure. Describes foundational payment methodologies for standard covered services, including primary coverage determinations. This refers to payment methodologies that establish the fundamental reimbursement structure, not exceptions or adjustments to it. Examples: 'covered services' 'Covered Services not included...', 'services primary to Medicare', etc.",
-        "PAYMENT_CARVEOUT": "Describes payments for specific services, procedures, level designations ('Secondary', 'Primary', 'Tertiary', etc), or specific DRG or codes that are carved out from the base/foundational payment methodology with distinct payment terms. These are exceptions or specialty payments that differ from the payments for standard/ base services. Examples include 'Radiology covered services', 'Anesthesia covered services', 'Pharmaceuticals', 'HEMATOCRIT (CPT CODE: 85014)', and level designations such as 'Secondary', 'Primary', 'Tertiary', 'Progressive Care'. Do NOT classify as payment carveout if the service represents a foundational coverage determination (such as primary payer methodologies in dual products) rather than a different payment to standard one.",
+        "PAYMENT_CARVEOUT": "Describes payments for specific services, procedures, level designations ('Secondary', 'Primary', 'Tertiary', etc), or specific DRG or codes or specific ages('Child','Adolescent','Adult', etc) that are carved out from the base/foundational payment methodology with distinct payment terms. These are exceptions or specialty payments that differ from the payments for standard/ base services. Examples include 'Radiology covered services', 'Anesthesia covered services', 'Pharmaceuticals', 'HEMATOCRIT (CPT CODE: 85014)', and level designations such as 'Secondary', 'Primary', 'Tertiary', 'Progressive Care'. Do NOT classify as payment carveout if the service represents a foundational coverage determination (such as primary payer methodologies in dual products) rather than a different payment to standard one.",
         "UNLISTED_CODE": "Describes payments for codes that are not listed on a fee schedule. This is similar to DEFAULT_TERM. Only populate with Y if the Service or Methodology specifically mentions Codes.",
         "ADDITION": "Describes payments that include a supplemental amount added to or above the base reimbursement rate. Populate with Y if the Methodology describes any additional payments, supplemental amounts, or add-on fees beyond the standard reimbursement.",
         "TRIGGER_CAP": "Describes a new payment methodology which becomes applicable/ gets triggered after a defined quantitative threshold is reached. Unlike supplemental payments, this refers to fundamentally changed new reimbursement methodology applicable only beyond the threshold. Valid thresholds can be based on dollar amounts, number of days, visits, units, or other measurable metrics (but not qualitative thresholds, e.g., 'where there is no Marketplace Medicare Rate'). Look for language indicating a clear change in the payment methodology when a defined quantitative threshold is exceeded, such as 'when charges exceed X, pay Y', or 'after 3 days, payment changes to $1,200 per diem'. Do NOT classify as TRIGGER_CAP if the term better fits the criteria for Outlier, Stop-Loss, or simple thresholds.",