Ohio Admin. Code 5160-2-79 - Reimbursement for LARC devices

(A) Notwithstanding the provisions of rules 5160-2-65 and 5160-2-75 of the Administrative Code, long-acting reversible contraceptive (LARC) devices may be billed separately when provided during an inpatient hospitalization.

(B) LARC devices may include intrauterine devices (IUD) and subdermal contraceptive implants.

(C) Implementation and billing procedures.

(1) The provisions of this rule are effective for claims associated with the provision of a LARC device in an inpatient hospital setting on or after the effective date of this rule.

(2) Only one outpatient claim for a LARC device may be submitted for a recipient in conjunction with an inpatient obstetrical delivery claim.

(D) Payment for LARC devices.

(1) Payment for the LARC device will be made in accordance with paragraph (E) of rule 5160-4-12 of the Administrative Code, at the rate in effect on the date of service.

(2) The corresponding inpatient obstetrical delivery claim will be paid in accordance with rule 5160-2-65 of the Administrative Code.

Notes

Ohio Admin. Code 5160-2-79

Effective: 7/6/2017
Five Year Review (FYR) Dates: 07/06/2022
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.721