Utah Admin. Code R414-1B-2 - Definitions

Current through Bulletin 2022-07, April 1, 2022

(1) "Abortion billing code" means those codes used to bill for services that are directly or indirectly related to an abortion and are found in the current editions of the:
(a) Current Procedural Terminology (CPT) manual of the American Medical Association; and
(b) International Classification of Diseases (ICD): Clinical Modification, or Procedural Coding System (PCS).
(2) "Certification" or "Certify" means submitting to the Division of Medicaid and Health Financing, Utah Department of Health, a Department-approved document signed by one authorized to act on behalf of a Medicaid provider.
(3) "Public funds" means money of the state, its institutions or its political subdivisions used to pay or otherwise reimburse a person, agency, or facility and money received under Title XIX of the federal Social Security Act. "Public funds" does not include (i) clinical revenue generated from nongovernmental payors; or (ii) gift or donor funds from third party nongovernmental sources.
(4) "Services" means all covered services reimbursable under the Medicaid State Plan and that are limited by federal guidelines set forth by the federal Social Security Act, Title 42 of the Code of Federal Regulations, Section R414-1-5, and Utah Medicaid Provider Manuals.


Utah Admin. Code R414-1B-2
Amended by Utah State Bulletin Number 2015-14, effective 7/1/2015

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