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Add diagnosis code to negotiated price object #759

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1 change: 1 addition & 0 deletions schemas/in-network-rates/README.md
Original file line number Diff line number Diff line change
Expand Up @@ -103,6 +103,7 @@ The negotiated price object contains negotiated pricing information that the typ
| **service_code** | Place of Service Code | An array of two-digit strings | The [CMS-maintained two-digit code](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set) that is placed on a professional claim to indicate the setting in which a service was provided. When attribute of `billing_class` has the value of "professional", `service_code` is required. | No |
| **billing_class** | Billing Class | String | Allowed values: "professional", "institutional", "both" | Yes |
| **billing_code_modifier** | Billing Code Modifier | Array | An array of strings. There are certain billing code types that allow for modifiers (e.g. The CPT coding type allows for modifiers). If a negotiated rate for a billing code type is dependent on a modifier for the reported item or service, then an additional negotiated price object should be included to represent the difference. | No |
| **diagnosis_code** | Diagnosis Code | Array | An array of strings. The [NCHS-maintained ICD-10 code](https://www.cdc.gov/nchs/icd/icd-10-cm/index.html) that is placed on a claim to indicate the patient diagnosis. This can be supplied to differentiate rates based on diagnosis for the same service code.| No |
| **additional_information** | Additional Information | String | The additional information text field can be used to provide context for negotiated arrangements that do not fit the existing schema format. Please open a Github discussion to ask a question about your situation if you plan to use this attribute. | No |

##### Additional Notes
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8 changes: 8 additions & 0 deletions schemas/in-network-rates/in-network-rates.json
Original file line number Diff line number Diff line change
Expand Up @@ -410,6 +410,14 @@
"uniqueItems": true,
"default": []
},
"diagnosis_code": {
"type": "array",
"items": {
"type": "string"
},
"uniqueItems": true,
"default": []
},
"negotiated_rate": {
"type": "number"
},
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