Ohio Admin. Code 5160-1-10 - Limitations on elective obstetric deliveries

(A) Payment for any cesarean section, labor induction, or any delivery following labor induction is subject to the following criteria:
(1) Gestational age of the fetus must be determined to be at least thirty-nine weeks;

or

(2) If a delivery occurs prior to thirty-nine weeks gestation, maternal and/or fetal conditions must indicate medical necessity for the delivery.
(B) Cesarean sections, labor inductions, or any deliveries following labor induction that occur prior to thirty-nine weeks gestation that are not considered medically necessary are not eligible for payment.

Notes

Ohio Admin. Code 5160-1-10
Effective: 5/1/2015
Five Year Review (FYR) Dates: 5/1/2020
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02

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