Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 202 - Hospital Services
Chapter 5 - Hospital Procedures
Rule 23-202-5.6 - Hysterectomy
Universal Citation: MS Code of Rules 23-202-5.6
Current through September 24, 2024
A. The Division of Medicaid defines a hysterectomy as the surgical removal of the uterus.
B. The Division of Medicaid covers a hysterectomy when medically necessary in an inpatient or outpatient setting in accordance with current standards of medical practice and when:
1. Prior to the hysterectomy:
a) The person who secured authorization to
perform the hysterectomy has informed the beneficiary and guardian/legal
representative, if any, orally and in writing that the hysterectomy will make
the beneficiary permanently incapable of reproducing, and
b) The beneficiary or guardian/legal
representative, the person that secured authorization for the hysterectomy, and
the physician who performs the hysterectomy have completed and signed the
appropriate section(s) of the Hysterectomy Acknowledgement Form;
2. The beneficiary is already
sterile before the hysterectomy and the physician certifies in writing on the
Hysterectomy Acknowledgement Form that the beneficiary was already sterile at
the time of the hysterectomy, and states the cause of sterility; or
3. The beneficiary requires a hysterectomy
because of a life-threating emergency situation in which the physician
determines that prior acknowledgement is not possible, and the physician
certifies in writing on the Hysterectomy Acknowledgement Form that the
hysterectomy was performed under a life-threatening emergency situation in
which he or she determined prior acknowledgement was not possible and documents
a description of the nature of the emergency.
C. The Division of Medicaid does not cover a hysterectomy when:
1. It is performed solely
for the purpose of rendering a beneficiary permanently incapable of
reproducing, or
2. There was more
than one (1) purpose to the hysterectomy and it would not have been performed
but for the purpose of rendering the beneficiary permanently incapable of
reproducing.
42 CFR § 441.255; Miss. Code Ann. §§ 43-13-117, 43-13-121.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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