RMCs define standard actions for the reason code and can be overridden by scenario using an _____________ or a ____________ record.

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RMCs establish the standard action tied to each reason code, giving a consistent response across most cases. To handle exceptions in specific scenarios, overrides are allowed using two mechanisms: an extension record, which adds or modifies details to adjust the action for a particular case; and a rule record, which encodes conditional logic to apply a different action when certain criteria are met. For example, the default action for a given reason code might be denial, but a rule record could switch to an appeal or special adjustment if the claim meets payer-specific conditions, while an extension record could tweak the action for a specific provider type or scenario. Other terms like amendment/directive or guideline/policy are broader governance concepts, not the operational override mechanisms used here, and terms like schema don’t capture the override behavior as clearly.