5160-21-01 Medicaid covered reproductive health services: preconception care services.

 

 

 

TO BE RESCINDED

 

5160-21-01                  Medicaid covered reproductive health services: preconception care services.

 

 

 

(A)  "Preconception care" means medicaid-covered preventive medicine services provided prior to a pregnancy for the purpose of achieving optimal outcome of future pregnancies.

 

(B)  Medicaid covered preconception care services may include, but are not limited to:

 

(1)  Laboratory tests and procedures including but not limited to:

 

(a)     Screening, diagnostic, and counseling services for detection of genetic anomalies and/or hereditary metabolic disorders, including but not limited to:

 

(i)       Chromosomal  anomalies  (in  non-pregnant  patients)  that  have neonatal implications;

 

(ii)   Sickle cell and other abnormal hemoglobin syndromes;

 

(iii)    Metabolic disorders such as phenylketonuria (PKU), galactosemia, or homocystinuria; and

 

(iv)   Cystic fibrosis (carrier status);

 

(b)   Screening for, diagnosis of, and treatment of sexually transmitted diseases and infections;

 

(2)     Individual preventive medicine counseling and or risk factor reduction(s) (health education), in accordance with appendix DD to rule 5101:3-1-60 of the Administrative Code.

 

(C)  For reimbursement of preconception care services medicaid providers must use:

 

(1)    Valid medicaid-covered CPT and/or HCPCS procedure codes as defined in paragraph (D) of rule 5101:3-1-19.3 of the Administrative Code; and

 

(2)   Appropriate "International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)" diagnosis codes V26.31 through V26.4, V26.8, and/or V26.9 to indicate an encounter for preconception care.

 

 

5160-21-01         Effective:	TO BE RESCINDED         07/01/2016	2
Five Year Review (FYR) Dates:	02/03/2016
CERTIFIED ELECTRONICALLY
Certification
05/27/2016
Date
Promulgated Under:	119.03
Statutory Authority:	5164.02
Rule Amplifies:	5162.03, 5164.02, 5164.70
Prior Effective Dates:	07/01/2009