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