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Request for an 1115 Waiver to Provide Family Planning Coverage to Women and Men between the Ages of 18 and 49 with Gross Income Below 200 Percent of Poverty Prepared by New Jersey Division of Medical Assistance and Health Services New Jersey Department of Human Services October 2009 New Jersey is applying for this waiver to create a program called the NJ Family Planning Expansion Project with the purpose of expanding family planning services to a new population of women; which will help them plan their pregnancies therefore reducing the social and economic costs associated with unintended and mistimed pregnancies. It intends to cover women and men between the ages of 18 and 49 with income equal to or below 200% of the federal poverty level (FPL). Background The New Jersey Department of Human Services (NJ DHS), Division of Medical Assistance and Health Services (NJ DMAHS), administers the Medicaid and NJ FamilyCare programs. The Medicaid program provides health insurance to parents/caretakers and dependent children, pregnant women and people who are aged, blind or disabled. The NJ FamilyCare program is a health insurance program for uninsured children whose family income is too high for them to qualify for “traditional” New Jersey Medicaid but not high enough to be able to afford private health insurance. Some low-income uninsured parents/caretakers are also eligible for NJ FamilyCare. Currently, there are over 1 million beneficiaries enrolled in NJ FamilyCare/Medicaid. NJ FamilyCare/Medicaid currently covers pregnant women with income equal to or below 200% FPL. These women are covered 60-days post partum before being terminated from the program. NJ FamilyCare/Medicaid does not cover women if they are over 20, have no dependent children, are not pregnant or disabled. Currently, women in New Jersey who do not have private health coverage must pay for family planning services themselves or seek services at Title X family planning clinics, which are funded by a federal grant program to provide family planning services, or a Federally Qualified Health Center (FQHC). Current Situation New Jersey has a population of 8.7 million residents, 51% of which are females. Almost 42% of the women in New Jersey are in their childbearing years (15-44 years of age). Over 131,000 individuals including over 123,000 women and over 8,000 men used a Title X clinic in 2008 and over 126,000 are under 200% federal poverty level (FPL) of which over 65,000 were uninsured . i The Federally Qualified Health Centers had over 19,000 women access their clinics for family planning services.

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According to the Guttmacher Institute, “In New Jersey, over 211,000 of the 1.8 million women of childbearing age becomes pregnant each year. Fifty-five percent of these pregnancies result in live births and 31% result in abortions; the remainder end in miscarriage.” ii Over 1 million women in New Jersey are in need of contraceptive services and supplies. Almost 400,000 of these women have incomes below 250% FPL and are in need of publicly supported family planning services. iii “In New Jersey, 9% of women aged 15-44 have incomes below the federal poverty level, and 20% of all women in this age-group are uninsured.” iv According to the NJ Center for Health Statistics, over the past several decades, birth rates have declined among younger women while rising among older women…more that half of births (55%) occurred to women aged 25-34 years. v The Guttmacher Institute Contraception Counts states, “the United State has one of the highest rates of unintended pregnancy in the industrialized world…and states can play an active role in women avoiding unintended pregnancies.” vi Nationally, about 60% of all pregnancies are unintended, mistimed or unwanted. vii An estimated one out of every three recent births in New Jersey was either mistimed (26%) or unwanted (8%) pregnancy. viii There are many risks associated with unintended pregnancies. Women with unintended pregnancies are 1.6 times more likely to delay entry into prenatal care, which can increase the health risks for the mother and baby. ix x xi xii Unintended or mistimed pregnancies can lead to complications including pre-term delivery and low birth weight. xiii xiv xv In New Jersey, 10% of all births are preterm and 8% of babies have low birth weight.

Project Goals and Objectives This project will allow NJ FamilyCare/Medicaid to expand family planning services to a new population of women and men. The project goal and objectives for the NJ Family Planning Expansion project is to help women plan their pregnancies therefore reducing the social and economic costs associated with unintended and mistimed pregnancies. Goal Reduce the number of unintended and mistimed pregnancies and improve maternal health and newborn outcomes Objectives o Increase the number of women and men receiving family planning services from Medicaid o Reduce the number of pregnancies for the women in the waiver population o Reduce the proportion of Medicaid births spaced less than two years apart for women in the waiver population

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o Decrease the number of Medicaid paid pregnancies and deliveries, which will reduce annual expenditures for prenatal care, delivery and newborn care. Project Design Provider Network New Jersey intends to use the current Title X clinics and the FQHCS as the provider network for this project. Family planning clinics in New Jersey play a vital role in the reproductive health of low-income women. According to the Center for Reproductive Rights, family planning clinics “serve as an entry point into the health-care system for young women and low-income people in this country…and offer contraceptive services and education that prevent unintended pregnancy, testing and treatment for sexually transmissible infections, and other primary reproductive health care.” xvi In New Jersey, publicly funded family planning clinics help women prevent 30,200 unintended pregnancies each year.” xvii There are currently 16 Title X agencies with 55 operating clinic sites statewide, with at least one in every county, and all are enrolled as Fee-For-Service (FFS) Medicaid providers. In New Jersey there are two Title X grantees, the Department of Health and Senior Services and the New Jersey Family Planning League. The Title X Federal funds are allocated through 11 New Jersey Department of Health and Senior Services delegate agencies and 5 New Jersey Family Planning League delegate agencies. See Appendix A for a complete list of clinics. The FQHCs in New Jersey provide comprehensive community-based primary health care with an emphasis on maternal and child health which seeks to provide quality care for people from prenatal to old age. xviii There are currently 20 FQHCs statewide, with 99 operating clinics serving 19 of the 21 counties. See Appendix B for a complete list of FQHCs.

Primary Care Referrals When a woman or man applies for the NJ Family Planning Expansion Program, it is required as part of this waiver that the provider make the necessary primary care referral. When appropriate the Title X clinics may refer clients to the FQHCs and the FQHCs may refer to the Title X clinics. The Title X clinics and FQHCs have an existing relationship and refer clients on an on-going basis. The New Jersey Primary Care Association, the organization that represents the FQHCs, is supportive of the NJ Family Planning Expansion Project to provide Medicaid family planning services to more women in New Jersey. See Appendix C for their letter in support of this waiver.

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Eligible Population The NJ Family Planning Expansion Project will expand family planning services to qualified women and men between the ages of 18-49 with gross income equal to or below 200% FPL. Table 1 shows the number of women and men we estimate to be eligible and accessing services for each demonstration year based on the number of woman and men currently accessing services at the Title X clinics and FQHCs for family planning services.

Table 1 Year Year 1 Year 2 Year 3 Year 4 Year 5

Enrollment 66,057 67,793 69,601 71,485 73,451

Eligibility Determination New Jersey will be using a Point-of-Service Application to determine eligibility for women and men between the age of 18 and 49 who present at clinics for family planning services who do not otherwise qualify for NJ FamilyCare/Medicaid. The use of Point-of Service application allows the applicant to apply and obtain family planning services immediately and that the provider is reimbursed for these services. An electronic application will be completed at the clinic. The electronic application will then be sent to the statewide eligibility determination agency for processing – the on-line application will mirror the NJ FamilyCare/Medicaid online application. The application captures information about income, health insurance, family size and citizenship/immigration status. The applicant will be allowed to self-declare income. The clinic will not be responsible for obtaining proof of income, however the statewide eligibility determination agency staff will be required to check existing databases to verify that the income provided is accurate. If the income cannot be verified the vendor will ask for additional income information from the applicant, such as pay stubs or tax returns. The statewide eligibility determination agency will have the ability to use existing databases to verify the citizenship/immigration status if necessary, therefore helping to expedite the enrollment process. Once a final eligibility determination has been made a card will be sent to the client and the clinic can verify eligibility in the system and bill for the services provided on the initial visit.

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Eligibility Redetermination Process The statewide eligibility determination agency will renew those enrolled in the NJ Family Planning Expansion Project annually, using an administrative renewal process if possible. Otherwise, a pre-printed renewal form will be sent 75 days before their 12month period of eligibility ends and one reminder notice 45 days before termination. Covered Services The Family Planning Expansion Project will cover family planning services currently provided through NJ FamilyCare/Medicaid for women and men through family planning clinics, FQHCs and hospitals. See Appendix D for a list of covered services.

Outreach Outreach will be important for the success of this program, enabling us to maximize enrollment of eligible women and men. Brochures and posters will be developed with information about the NJ Family Planning Expansion Project and will be made available at various agencies throughout New Jersey including Title X clinics, Federally Qualified Health Centers, Hospitals, Maternal and Child Heath Consortia, Healthy Mothers Health Babies, WIC, Local County Welfare Agencies, NJ FamilyCare Outreach offices and Medical Assistance Customer Centers. DMAHS will be updating their general NJ FamilyCare/Medicaid training module, presented to various groups statewide. In addition they will train clinic staff on the program eligibility requirements and completing the on-line application. Public Process An Interdepartmental workgroup, with the Department of Human Services and Department of Health and Senior Services, was established to develop the NJ Family Planning Expansion project in New Jersey. Staff from these two departments met on a regular basis to develop the waiver application. Staff from the Department of Human Services and Department of Health and Senior Services met with members of the NJ Family Planning Association, NJ Family Planning League and Planned Parenthood to discuss the proposed NJ Family Planning Expansion project. They were given an opportunity to review the waiver application and offer comment. We have incorporated many of the recommendations suggested by these groups. Commissioner Heather Howard from the New Jersey Department of Health and Senior Services convened a Prenatal Task Force in February 2008. The Task Force

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included experts in the field of Maternal and Child Health. The Commissioner’s Task Force on Prenatal Care found that unintended pregnancy or a lack of awareness of a pregnancy can delay the initiation of early prenatal care. The Task Force strongly recommended that efforts to improve access to early prenatal care must address the factors related to unintended pregnancy and lack of early pregnancy awareness by focusing on women before they become pregnant. Governor Corzine held a forum on the benefits of expanding family planning services, which was attended by over 40 advocates, healthcare and family planning providers. The family planning waiver was major point of discussion at this forum. It was a chance for advocates to voice their issues, concerns and recommendations on how to improve the process. The final submitted version of the waiver request is posted on the Department of Human Services website. Notices posted in newspapers, medical assistance customer centers, county welfare agencies, and on the DHS website will advise that the waiver request is being submitted to CMS, and offer the opportunity for additional comments. Proposed rules are being drafted. There will be a 60 day public comment period before adoption of the final regulations.

Project Administration The New Jersey Department of Human Services, Division of Medical Assistance and Health Services, administers the NJ FamilyCare/Medicaid in New Jersey. For the NJ Family Planning Expansion Project, clients will be enrolled in Fee-for-Service (FFS) Medicaid. Women and men can apply and receive services through one of the Title X clinics or FQHCs statewide who are also Medicaid FFS providers. Our Statewide Eligibility Determination Agency will process the applications for this project. Evaluation The following hypotheses have been developed to help New Jersey demonstrate the effectiveness of their waiver over five years to meet the goals and objectives that have been outlined for this project. Hypothesis 1:

The demonstration waiver will result in an increase in number of eligible women and men aged 18-49 receiving Medicaid paid family planning services in New Jersey. xix

Measure:

The number of women and men who receive a Medicaid paid family planning service to be measured at the end of every waiver year.

Data required:

The number of women and men uniquely identified as part of the waiver receiving a Medicaid paid family planning service.

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Data Source:

New Jersey’s Medicaid Management Information System (NJMMIS), which captures claim and financial information for all Medicaid recipients.

Hypothesis 2:

The demonstration waiver will result in the reduction of pregnancies of women aged 18-49 enrolled in the NJ Family Planning Expansion Project compared to pregnancies among all New Jersey women between 18 and 49.

Measure:

The number of pregnancies experienced by a sample population of women after enrolling in the waiver as compared to the number of self-reported pregnancies of women in the waiver population prior to them enrolling in the waiver.

Data required:

Enrollment data from claims information from NJMMIS, statewide eligibility determination agency report from the on-line application

Data source:

Statewide eligibility determination agency reports and NJMMIS

Hypothesis 3:

The demonstration waiver will result in an increased spacing of pregnancies among women aged 18-49 enrolled in the NJ Family Planning Expansion Project.

Measure:

The spacing of pregnancies experienced by a sample population of women with a Medicaid paid birth during a specific fiscal year that has a subsequent Medicaid paid birth within two years.

Data required:

Eligibility and claims information from NJMMIS

Data source:

NJMMIS

Hypothesis 4:

The demonstration waiver will produce a net annual savings in State and Federal Medicaid expenditures for birth-related services per women aged 18-49 in the Medicaid program. xx

Measure:

The estimated fiscal year Medicaid savings from births prevented by the waiver less fiscal year Medicaid family planning expenditures for the waiver target population, based on a sample of women who used the Title X clinic and subsequently enrolled in the waiver

Data required:

The difference between the expected number of Medicaid paid births, due to a conception in a given fiscal year, to the waiver target population and the actual number of Medicaid paid births to this population multiplied by the average associated prenatal, birth,

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newborn and infant care costs. The total fiscal year Medicaid family planning expenditures for the waiver target population. Data Source:

New Jersey Medicaid Management Information System, which includes claim and financial information.

Conclusion This waiver application has outlined the need for this project in New Jersey. The challenge is how to get those women who have never obtained family planning services, as well as those who have received them but have fallen off the Medicaid roles after giving birth, to make family planning a part of their everyday lives. Our hope is to cultivate in those whom we enroll in the NJ Family Planning Expansion Project a realization that regularity in obtaining these services is an important part of their reproductive health and quality of life. This project’s goal is to make it easier for women of child bearing age to obtain routine family planning services and care, and to ensure these services are ongoing by maintaining continuous enrollment in the NJ Family Planning Expansion Project.

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Appendices Appendix A

New Jersey Family Planning Agencies/Clinic Sites by County, 2008 (16 agencies / 55 clinic sites operating) ATLANTIC Planned Parenthood of Southern New Jersey • •

• Bridgeton • Vineland • Millville ESSEX Planned Parenthood of Metropolitan New Jersey

Atlantic City Pomona (Stockton State College)

BERGEN Planned Parenthood of Greater Northern New Jersey • •

• • • •

Englewood Hackensack

North Hudson Community Health Center •

Newark Beth Israel Medical Center •

Garfield

BURLINGTON Burlington County Health Department • •



Westampton – Main site for agency Browns Mills

• •

Edgewater Park

Glassboro – Main site for agency Glassboro (Rowan University)

HUDSON Horizon Health Center •

Camden – Main site for agency Bellmawr Cherry Hill

Jersey City – Only site for agency

Bayonne Department of Health Women’s Health Center

CAPE MAY Cape May County Department of Health •

Newark – Only site for agency

GLOUCESTER FamCare

CAMDEN Planned Parenthood of Southern New Jersey • • •

Newark/Irvington – Only site for agency

UMDNJ – University OB/GYN Associates

Planned Parenthood of Southern New Jersey •

Newark (Downtown) – Main site for agency Newark (Ironbound) Montclair East Orange



Cape May Court House – Only site for agency

Bayonne – Only site for agency

Hoboken Family Planning • •

CUMBERLAND FamCare

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Hoboken – Main site for agency West New York

• •

North Hudson Community Health Center • • • •

West New York – Main site for agency Union City Jersey City North Bergen

North Hudson Community Health Center • •



Flemington

• •



Trenton (Downtown) – Main site for agency Hamilton Square Trenton (College of New Jersey)



New Brunswick Perth Amboy Spotswood



• •

Shrewsbury – Main site for agency Freehold Hazlet

Elizabeth Plainfield

WARREN Planned Parenthood of Greater Northern New Jersey •

Morristown – Main site for agency Dover

OCEAN Family Planning Center of Ocean County •

Newton

UNION Planned Parenthood of Greater Northern New Jersey

MORRIS Planned Parenthood of Greater Northern New Jersey • •

Somerville – Only site for agency

SUSSEX Planned Parenthood of Greater Northern New Jersey

MONMOUTH Planned Parenthood of Central New Jersey • • •

Manville

Women’s Health and Counseling Center

MIDDLESEX Planned Parenthood of Central New Jersey • • •

Pennsville

SOMERSET Planned Parenthood of Greater Northern New Jersey

MERCER Planned Parenthood Association of the Mercer Area •

Passaic (Main Avenue) Passaic (8th Street)

SALEM FamCare

HUNTERDON Planned Parenthood of Greater Northern New Jersey •

Paterson Pompton Lakes

Lakewood – Only (current) site for agency

PASSAIC Planned Parenthood of Metropolitan New Jersey

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Phillipsburg

Appendix B

New Jersey Federally Qualified Health Centers Newark Community Health Centers 741 Broadway Newark, New Jersey 07104 Newark Homeless Health Care Project 110 William Street, Room 200 Newark, NJ 07102

AtlantiCare Health Services Mission Health Care 2009 Bacharach Blvd. Atlantic City, New Jersey 08401 Camcare Health Corporation Gateway Health Center 817 Federal Street Camden, New Jersey 08103

North Hudson Community Action Corporation 5301 Broadway West New York, New Jersey 07093

Community Health Care PO Box 597 105 Manheim Avenue Bridgeton, New Jersey 08302

Ocean Health Initiatives, Inc. 101 Second Street Lakewood, New Jersey 08701

Eric B. Chandler Health Center 277 George Street New Brunswick, New Jersey 08901

Paterson Community Health Center 32 Clinton Street Paterson, New Jersey 07522

Henry J. Austin Health Center 321 North Warren Street Trenton, New Jersey 08618

Plainfield Health Center 1700-58 Myrtle Avenue Plainfield, New Jersey 07063-1038

Horizon Health Center 714 Bergen Avenue Jersey City, New Jersey 07306

Project H.O.P.E., Inc. Bergen Lanning Health Center 439 Clinton Street Camden, New Jersey 08103

Jewish Renaissance Health Center 272A Hobart Street Perth Amboy, New Jersey 08862

Southern Jersey Family Medical Centers 1 White Horse Center Hammonton, New Jersey 08037

Lakewood Resource and Referral Center, Inc. 1771 Route 9 Lakewood, NJ 08701 Metropolitan Family Health Network, Inc. 935 Garfield Avenue Jersey City, New Jersey 07304

Visiting Nurse Services of Central Jersey Community Health Center 1301 Main Street Asbury Park, New Jersey 07712

Monmouth Family Health Center 270 Broadway Long Branch, New Jersey 07740

Zufall Health Center 17 S. Warren Street Dover, New Jersey 07801

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Appendix C

NJPCA ________________________________________________________________________________________________ New Jersey Primary Care Association, Inc.

Katherine Grant-Davis President & CEO

March 25, 2009 John Guhl Director Department of Human Services Division of Medical Assistance and Health Services PO Box 712 Trenton, NJ 08625-0712 Dear Mr. Guhl; On behalf of the New Jersey Primary Care Association (NJPCA), I am pleased to write this letter of support for your Family Planning Waiver to provide family planning coverage to women between the ages of 18 and 49 with income under 200% of the federal poverty level. As you know, NJPCA is a not-for-profit organization that represents Federally Qualified Health Care (FQHC) centers statewide, serving over 350,000 patients in 19 of the 21 counties. FQHCs have a particular emphasis on maternal and child health and providing quality primary care from prenatal to old age. NJPCA has worked collaboratively with the Division of Medical Assistance and Health Services (DMAHS) on a number of projects over the years and look forward to working on the development and implementation of the New Jersey Family Planning Expansion Project and playing an active role as a part of the provider network as well as supporting the referral for primary care to our FQHCs for this new eligibility group. Sincerely,

Katherine Grant-Davis President and CEO KGD:DVZ

3836 Quakerbridge Road, Suite 201, Hamilton, NJ 08619 (609) 689-9930 FAX (609) 689-9940/41

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Appendix D Family Planning Codes

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

11975

INSERT/REINSERT IMPLANT.CONTRA

ALWAYS FAMILY PLANNING

F

11975

INSERT/REINSERT IMPLANT,CONTA

ALWAYS FAMILY PLANNING

F

11975

INSERT/REINSERT IMPLANT,CONTA

F

11976

REMOVE WO REINSERT IMPL.CON.CA

11976

REMOVE WO REINSERT,IMPL.CON.CA

11976

REMOVE WO REINSERT,IMPL.CON.CA

11977

REM.REINS.IMPLANT CONTRA.CAPS.

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

11977

REM.REINS.IMPLANT CONTR.CAPS.

ALWAYS FAMILY PLANNING

F

11981

INSERT NON-BIO DRUG DELIV IMPL

F

11981

INSERT NON-BIO DRUG DELIV IMPL

11982

REMOVAL NON-BIO DRUG DELIV IMP

11982

REMOVAL NON-BIO DRUG DELIV IMP

11983

REM W/INS NON-BIO DRUG DEL IMP

11983

REM W/INS NON-BIO DRUG DEL IMP

36415

ROUTINE VENIPUNCTURE FOR COLLE

36415

ROUTINE VENIPUNCTURE FOR COLLE

36415

ROUTINE VENIPUNCTURE FOR COLLE

36416

COLLECT CAP BLOOD SPECIMEN

37788

PENILE RENASCUL.ARTERY,W/WO VG

52010

CYSTOSCOPY W/ DUCT CATHETER

54056

DESTROY PENILE LESION;CRYOSURG

54300

PLASTIC REPAIR FOR CHORDEE

54304

REVISE PENIS/CORRECT CHORDEE

54308

URETHROPLASTY...LESS THAN 3 CM

54312

URETHROPLASTY...;MORE THAN 3 C

54316

URETHROPLASTY/RELEASE FROM SCR

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

13

F F F F

B F B F B B B B B M B M M M M M M

Procedure Code

Proc Layman Name

54318

3RD STAGE HYPOSPADIAS REPAIR

54322

ONE STAGE REP,W/ SIMP.MEATAL A

54324

1 STAGE REP.URETHROPLASTY-SKIN

54326

1 STAGE REP.URETHROPLASTY-MOB.

54328

1 STAGE REP,CORRECT CHORDEE&UR

54332

1 STAGE PROX PEMILE/PENOSCROTA

54336

1 STAGE PERINEAL HYPOSPADIAS R

54340

REP.HYPOSPADIAS COMPLICATIONS,

54344

REP.HYPOSPADIAS COMPLICATION/F

54348

REP.HYPOSPADIAS COMPLICATION/E

54352

REP HYPOSPADIAS CRIPPLE...EXTE

54360

PLASTIC PENILE REPAIR/ANGULATI

54400

INSERT PENILE PROSTH,NON-INFLA

54401

INSERTION OF PENILE PROSTHESIS

54405

INSERT INFLATABLE PENILE PROST

54450

PREPUTIAL STRETCHING

54500

BIOPSY OF TESTIS

54505

BIOPSY OF TESTIS

54830

REMOVE EPIDIDYMIS LESION

55200

INCISION OF SPERM DUCT

55250

VASECTOMY, UNILATERAL OR BILAT

55300

PREPARATION,SPERM DUCT X-RAY

55450

LIGATION OF VAS DEFERENS

55520

REMOVAL OF SPERM CORD LESION

55530

REVISE SPERMATIC CORD VEINS

14

Proc AHSF Desc

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS STERILIZATION SOMETIMES FAMILY PLANNING ALWAYS STERILIZATION SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

Proc Valid Gender Code M M M M M M M M M M M M M M M M M M M M M M M M M

Procedure Code

Proc Layman Name

55535

REVISE SPERMATIC CORD VEINS

55540

REVISE HERNIA & SPERM VEINS

55600

INCISE SPERM DUCT POUCHES

55600

VESICULOTOMY;

55605

INCISE SPERM DUCT POUCH

55680

REMOVE SPERM POUCH LESION

55870

ELECTROEJACULATION

56501

DESTRY VULVA LESION(S);SIMPLE

57100

BIOPSY OF UTERUS LINING

57160

INSERT PESSARY

57170

FITTING OF DIAPHRAGM

57335

VAGINOPLASTY/ADRENOGENITAL SYS

57410

PELVIC EXAM UNDER ANESTHESIA

57415

REM. IMP. UNDER ANESTHESIA

57452

Proc AHSF Desc

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

Proc Valid Gender Code M M M M M M M F F

EXAMINATION OF VAGINA

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

57454

VAGINA EXAMINATION & BIOPSY

ALWAYS FAMILY PLANNING

F

57460

COLPOSCOPY;W/LOOP ELECT EXCIS

ALWAYS FAMILY PLANNING

F

57500

BIOPSY OF CERVIX

F

57505

ENDOCERVICAL CURETTAGE

57511

CRYOCAUTERY OF CERVIX

57720

REVISION OF CERVIX

57800

DILATION OF CERVICAL CANAL

57800

DILATION OF CERVICAL CANAL

58100

BIOPSY OF UTERUS LINING

58100

BIOPSY OF UTERUS LINING

58100

BIOPSY OF UTERUS LINING

58120

DIAGNOSTIC/THERAPEUTIC D&C

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

15

F F F F F F

F F F F F F F F F

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

58140

REMOVAL OF UTERUS LESION

58145

REMOVAL OF UTERUS LESION

58300

IUD BY CNP/CNS IN FPC

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

58300

INSERT IUD BY CNM IN FPC

ALWAYS FAMILY PLANNING

F

58300

IUD IN FPC

ALWAYS FAMILY PLANNING

F

58300

IUD BY CNP/CNS

ALWAYS FAMILY PLANNING

F

58300

INSERT IUD BY CNM

ALWAYS FAMILY PLANNING

F

58300

INSERT INTRAUTERINE DEVICE

ALWAYS FAMILY PLANNING

F

58301

REMOVE IUD BY CNP/CNS IN FPC

F

58301

REMOVE IUD BY CNM IN FP CLINIC

58301

REMOVE INTRAUTERINE DEVICE

58301

REMOVAL OF IUD BY CNM

58301

REMOVE INTRAUTERINE DEVICE

58340

INJECT FOR UTERUS/TUBE X-RAY

58400

UTERINE SUSPENSION

58540

REPIAR OF UTERINE ANOMALY

58565

HYSTEROSCOPY, STERILIZATION

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS STERILIZATION

58600

DIVISION OF FALLOPIAN TUBE

ALWAYS STERILIZATION

F

58605

DIVISION OF FALLOPIAN TUBE

ALWAYS STERILIZATION

F

58611

LIGATION/TRANSECT FALLOPIAN TU

ALWAYS STERILIZATION

F

58615

OCCLUSION OF FALLOPIAN TUBE, D

F

58660

SURG LAP W/LYSIS OF ADHESIONS

58670

SURG LAP W/FULG OF OVIDUCTS

ALWAYS STERILIZATION SOMETIMES FAMILY PLANNING SOMETIMES STERILIZATION

58671

SURG LAP W/OCCLUS OF OVIDUCTS

ALWAYS STERILIZATION

F

58700

REMOVAL OF FALLOPIAN TUBE

SOMETIMES STERILIZATION

F

58720

COMP/PART SALPINGO-OOPHORECTOM

F

58740

LYSIS OF ADHESIONS TUBES/OVARY

58750

PLASTIC REPAIR OF FALLOPIAN TU

58752

TUBOUTERINE IMPLANTATION

58760

FIMBRIOPLASTY

58770

SALPINGOSTOMY(SALPINGONEOSTOMY

SOMETIMES STERILIZATION SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY

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F F F

F F F F F F F F

F F

F F F F F

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

PLANNING 58900

BIOPSY OF OVARY(S)

74740

X-RAY FEMALE GENITAL TRACT,S&I

76856

ECHOGRAPHY, PELVIC, REAL TIME

76857

ECHOGRAPHY, PELVIC, LIMITED

76857

ECHOGRAPHY, PELVIC,LIMITED OR

76948

ECHOGRAPHY,SCROTUM AND CONTENT ULTRASONIC GUIDE,ASPIRE OVA,

81000

URINALYSIS WITH MICROSCOPY

81000

URINALYSIS WITH MICROSCOPY

81000

URINALYSIS WITH MICROSCOPY

81002

ROUTINE URINE ANALYSIS

81002

ROUTINE URINE ANALYSIS

81025

URINE PREG.TEST;VISUAL COLOR

81025

URINE PREG.TEST;VISUAL COLOR

81025

URINE PREG.TEST;VISUAL COLOR

82160

ANDROSTERONE; RIA

82465

ASSAY SERUM CHOLESTROL

82465

ASSAY SERUM CHOLESTEROL

82947

ASSAY BODY FLUID GLUCOSE

82947

ASSAY BODY FLUID, GLUCOSE

82947

ASSAY BODY FLUID, GLUCOSE

82948

STICK ASSAY OF BLOOD GLUCOSE

83516

IMMUNOASSAY FOR ANALYTE QUAL

83518

IMM.ANALYTE ANTIBODY QUAL.SEMI

83518

IMM.ANALYTE ANTIBODY QUAL.SEMI

84066

ASSAY PROSTATE PHOSPHATASE, RI

76870

17

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

F F B B B M F B B B B B F F F B B B B F B B B B B M

Procedure Code

Proc Layman Name

84702

GONADOTROPIN,CHORIONIC;QUANTIT

84702

GONADOTROPIN,CHORIONIC;QUANTIT

84703

GONADOTROPIN,CHORIONIC;QUALITA

84703

GONADOTROPIN,CHORIONIC;QUALITA

84703

GONADOTROPIN,CHORIONIC;QUALITA

85013

BLOOD COUNT SPUN MICROHEMATOCR

85013

BLOOD COUNT;SPUN MICROHEMATOCR

85018

HEMOGLOBIN, COLORIMETRIC

86255

FLUORESCENT ANTIBODY; SCREEN

86255

FLUORESCENT ANTIBODY; SCREEN

86256

FLUORESCENT ANTIBODY; TITER

86256

FLUORESCENT ANTIBODY; TITER

86359

T CELLS;TOTAL COUNT

86360

T CELLS;T4&T8, INCLUDING RATIO

86592

SYPHILIS TEST(S) ,QUALITATIVE

86592

SYPHILIS TEST(S),QUALITATIVE

86592

SYPHILIS TEST(S),QUALITATIVE

86593

SYPHILIS TEST, QUANTITATIVE

86631

ANTIBODY;CHLAMYDIA

86632

ANTIBODY;CHLAMYDIA, 1GM

86674

ANTIBODY;GIARDIA LAMBLIA

86687

HTLV I ANTI DECT IMMUNOASSAY

86688

ANTIBODY;HTLV-II

86689

HTLV I ANIT DECT CONFIRM TEST

86694

ANTIBODY;HERPES SIMPLEX,WONSPE

18

Proc AHSF Desc

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

Proc Valid Gender Code F F F F F B B B B B B B B B B F B B B B B B B B B

Procedure Code

Proc Layman Name

86695

ANTIBODY;HERPES SIMPLEX,TYPEI

86695

ANTIBODY;HERPES SIMPLEX,TYPE I

86696

HERPES SIMPLEX TYPE 2

86701

ANTIBODY:HIV 1

86701

ANTIBODY; HIV-1

86701

ANTIBODY:HIV 1

86702

ANTIBODY:HIV 2

86703

ANTIBODY;HIV-1&2,SINGLE ASSAY

86703

ANTIBODY;HIV-1&2,SINGLE ASSAY

86703

ANTIBODY;HIV-1&2,SINGLE ASSAY

86703

ANTIBODY;HIV-1&2,SINGLE ASSAY

86703

ANTIBODY;HIV-1&2,SINGLE ASSAY

86729

ANTIBODY;LYMPHOGRANULOMA VENER

86762

ANTIBODY;RUBELLA

86762

ANTIBODY;RUBELLA

86762

ANTIBODY;RUBELLA

86781

ANTIBODY; TREP.PALL.CONF.TEST

87075

CULTURE SPECIMEN, BACTERIA

87076

BACTERIA IDENTIFICATION

87086

URINE CULTURE,COLONY COUNT

87086

URINE CULTURE, COLONY COUNT

87110

CULTURE,CHLAMYDIA

87164

DARK FIELD EXAMINATION

87164

DARK FIELD EXAMINATION

87184

ANTIBIOTIC SENSITIVITY,EACH

87184

ANTIBIOTIC SENSITIVITY, EACH

87205

SMEAR, STAIN & INTERPRET, ROU

19

Proc AHSF Desc

Proc Valid Gender Code

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

B

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY

B

B B B F B B B

B F B B F F B B B B B B B B B B B B

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

PLANNING 87207

SMEAR, STAIN & INTERPRET, SPEC

87210

SMEAR, STAIN & INTERPRET, WET

87220

TISSUE EXAMINATION FOR FUNGI

87250

VIRUS INOCULATION FOR TEST

87270

CHAMYDIA TRACHOMATIS

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

87274

HERPES SIMPLEX VIRUS

ALWAYS FAMILY PLANNING

B

87320

INFECTIOUS AGENT CHLAMYDIA TRA

ALWAYS FAMILY PLANNING

B

87490

INFECT-AG-NUCLEIC-CHAMYDIA TRA

ALWAYS FAMILY PLANNING

B

87491

INFECT AG DECT DNA CHLAMYDIA

ALWAYS FAMILY PLANNING

B

87590

NEISSERIA GONORRHOEAE D-PROBE

ALWAYS FAMILY PLANNING

B

87591

NEISSERIA GONORRHOEAE AMPL

ALWAYS FAMILY PLANNING

B

87620

PAPILLOMAVIRVS-HUMAN- DIR-PROB

ALWAYS FAMILY PLANNING

B

87621

PAPILOMAVIRUS AMPL

ALWAYS FAMILY PLANNING

B

88141

CYTOPATH CER-VAG ANY REP

F

88141

CYTOPATH CER-VAG ANY REP

88142

CYTOPATH -AUTOMATED THIN PREP

88142

CYTOPATH -AUTOMATED THIN PREP

88143

CYTOPATH C/VAG T/LAYER MAN RE

88143

CYTOPATH C/VAG T/LAYER MAN RE

88147

CYTO/PATH C/VAG AUTOMATED P/S

88147

CYTO/PATH C/VAG AUTOMATED P/S

88148

CYTO/PATH C/VAG AUTO RESC

88148

CYTO/PATH C/VAG AUTO RESC

88150

CYTOPATHOLOGY, PAP SMEAR

88150

CYTOPATHOLOGY, PAP SMEAR

88152

CYTOPATH, W/MANUEL CYTO SCREEN

88152

CYTOPATH, W/MANUEL CYTO SCREEN

88153

CYTO/PATH C/VAG REDO

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

20

B B B B B

F F F F F F F F F F F F F F

Procedure Code

Proc Layman Name

88153

CYTO/PATH C/VAG REDO

88154

CYTOPATH C/VAG SELECT C/PHY S

88154

CYTOPATH C/VAG SELECT C/PHY S

88155

CYTOPATH,(PAP);W/ DEF.HORMONAL

88164

CYTOPATH SLIDES C/VAG MANUAL

88164

CYTOPATH SLIDES C/VAG MANUAL

88165

CYTOPATH TBS C/VAG REDO

88165

CYTOPATH TBS C/VAG REDO

88166

CYTOPATH TBS SYS C/VAG AUTO

88166

CYTOPATH TBS SYS C/VAG AUTO

88167

CYTOPATH TBS/SYS C/VAG SELECT

88167

CYTOPATH TBS/SYS C/VAG SELECT

88175

CYTO W/SCR BY AUTO, THIN LAYER

88305

COLPOSCOPY PATHOLOGY

89310

SEMEN ANALYSIS

89320

COMPLETE SEMEN ANALYSIS

89325

SPERM ANTOBODIES

89329

Proc AHSF Desc

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

Proc Valid Gender Code F F F F F F F F F F F F F B

SPERM EVAL.HAMSTER PENETRATION

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

89330

CERVICAL MUCUS PENETRATION TES

ALWAYS FAMILY PLANNING

B

90649

H PAPILLOMA VACC 3 DOSE IM

B

90706

IMMUNIZATION RUBELLA

90707

IMMUNIZATION ACTIVE MEASLES MU

90707

IMMUN MEASLES-MUMPS-RUBELLA

90746

HEPATITIS B VACCINE >19

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

90772

THER/PROPH/DIAG INJ, SC/IM

B

90772

THER/PROPH/DIAG INJ, SC/IM

96372

THERAPEUTIC PROPHY/DIAG INJECT

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

21

M M M M

B B B B

B B

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

96372

THERAPEUTIC PROPHYLACTIC OR

99201

E/M INITIAL FP VS IN FP CLINIC

SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99201

E/M INIT BRIEF FP VS/CNM FP CL

ALWAYS FAMILY PLANNING

F

99201

E/M INITIAL FP VS IN FP CLINIC

B

99201

E/M OFFICE/OP NEW PATIENT

99201

E/M INIT BRIEF FP VS/CNM FP CL

99201

E/M OFFICE/OP NEW PATIENT CNM

99201

E/M OFFICE/OP NEW PATIENT

99201

E/M OFFICE/OP NEW PATIENT

99202

E/M FP VISIT,NEW PATIENT FP CL

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99202

E/M INITIAL VS BY CNM IN FP CL

ALWAYS FAMILY PLANNING

F

99202

E/M FP VISIT,NEW PATIENT FP CL

B

99202

E/M OFFICE/OP NEW PATIENT

99202

E/M INITIAL VS BY CNM IN FP CL

99202

E/M OFFICE/OP NEW PATIENT CNM

99202

E/M OFFICE/OP NEW PATIENT

99202

E/M OFFICE/OP NEW PATIENT

99203

E/M INITIAL FP VS IN FP CLINIC

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99203

E/M INIT FP VS/CNM IN FP CL

ALWAYS FAMILY PLANNING

F

99203

E/M INITIAL FP VS IN FP CLINIC

B

99203

E/M OFFICE/OP NEW PATIENT

99203

E/M OFFICE/OP NEW PATIENT

99203

E/M INIT FP VS/CNM IN FP CL

99203

E/M OFFICE/OP NEW PATIENT CNM

99203

E/M OFFICE/OP NEW PATIENT

99203

E/M OFFICE/OP NEW PATIENT

99203

E/M OFFICE/OP NEW PATIENT

99204

E/M INITIAL FP VISIT FP CL

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99204

E/M OFFICE/OP NEW VISIT FP CL

ALWAYS FAMILY PLANNING

B

22

B B

B F F B B B

B F F B B B

F B F F B F B B

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

99204

E/M OFFICE/OP NEW PATIENT

99204

E/M OFFICE/OP NEW PATIENT CNM

99204

E/M OFFICE/OP NEW PATIENT

99204

E/M OFFICE/OP NEW PATIENT

99205

E/M OFFICE/OP NEW IN FP CL

99205

E/M OFFICE/OP NEW PATIENT

99205

E/M OFFICE/OP NEW PATIENT

99211

E/M F/U VISIT--FP CLINIC

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99211

E/M F/U VISIT BY CNM IN FP CL

ALWAYS FAMILY PLANNING

F

99211

E/M F/U VISIT--FP CLINIC

B

99211

E/M EST PT MINIMAL PROBLEM(S)

99211

E/M F/U VISIT BY CNM IN FP CL

99211

E/M ESTAB PT- VISIT BY CNM

99211

E/M EST PT MINIMAL PROBLEM(S)

99211

E/M EST PT MINIMAL PROBLEM(S)

99212

E/M - F/U VISIT IN FP CLININC

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99212

E/M F/U FP VS BY CNM/FP CLINIC

ALWAYS FAMILY PLANNING

F

99212

E/M - FP VISIT IN FP CLINIC

B

99212

E/M OFFICE/OP - ESTABLISHED PT

99212

E/M F/U FP VS BY CNM/FP CLINIC

99212

E/M ESTABLISHED PT. VS BY CNM

99212

E/M OFFICE/OP - ESTABLISHED PT

99212

E/M OFFICE/OP - ESTABLISHED PT

99213

E/M F/U VISIT FP CLINIC

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99213

E/M F/U VISIT FP CLINIC-CNM

ALWAYS FAMILY PLANNING

F

99213

E/M F/U VISIT FP CLINIC

B

99213

E/M OFFICE/OP ESTAB PATIENT

99213

E/M OFFICE/OP ESTAB PATIENT

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

23

B F B B B B B B

B F F B B B

B F F B B B

F B

Procedure Code

Proc Layman Name

99213

E/M F/U VISIT FP CLINIC-CNM

99213

E/M ESTABLISHED PT VISIT BY CN

99213

E/M OFFICE/OP ESTAB PATIENT

99213

E/M OFFICE/OP ESTAB PATIENT

99213

E/M OFFICE/OP ESTAB PATIENT

99214 99214

Proc AHSF Desc

Proc Valid Gender Code F

E/M FOLLOW UP VISIT-FP CLINIC

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

E/M FP VISIT BY CNM-FP CLINIC

ALWAYS FAMILY PLANNING

F

99214

E/M FOLLOW UP VISIT-FP CLINIC

B

99214

E/M OFFICE/OP ESTABLISHED PT

99214

E/M FP VISIT BY CNM-FP CLINIC

99214

E/M FOLLOW UP VS EST PT BY CNM

99214

E/M OFFICE/OP ESTABLISHED PT

99214

E/M OFFICE/OP ESTABLISHED PT

99215

E/M FU VISIT IN FP CL

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99215

E/M FP VISIT BY CNM IN FP CL

ALWAYS FAMILY PLANNING

F

99215

E/M FP VISIT-ESTAB PT IN FP CL

ALWAYS FAMILY PLANNING

B

99215

E/M FP VISIT BY CNM IN FP CL

F

99215

E/M VISIT-ESTSB PT-BY CNM

99215

E/M OFFICE/OP ESTAB PT VISIT

99215

E/M OFFICE/OP ESTAB PT VISIT

99221

E/M INITIAL HOSPITAL CARE

99221

E/M INITIAL HOSPITAL CARE CNM

99221

E/M INITIAL HOSPITAL CARE

99222

E/M INITIAL HOSPITAL CARE

99223

E/M INITIAL HOSPITAL CARE

99231

E/M SUBSEQUENT HOSPITAL CARE

99231

E/M SUBSEQUENT HOSPITAL CARE

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

24

F B F B B

B F F B B B

F B B B F B B B B F

Procedure Code

Proc Layman Name

99231

E/M SUBSEQUENT HOSPITAL CARE

99232

E/M SUBSEQUENT HOSPITAL CARE

99232

E/M SUBSEQUENT HOSPITAL CARE

99232

E/M SUBSEQUENT HOSPITAL CARE

99233

E/M SUBSEQUENT HOSPITAL CARE

99238

HOSPITAL DISCHARGE DAY MANAGEM

99241

E/M OFFICE/OP CONSULT NEW/EST

99242

E/M OFFICE/OP CONSULT NEW/EST

99243

E/M OFFICE/OP CONSULT NEW/EST

99244

E/M OFFICE/OP CONSULT NEW/EST

99245

E/M OFFICE/OP CONSULT NEW/EST

99251

E/M/INITIAL INPATIENT CONSULT

99252

E/M INITIAL IP/NF CONSULT NEW/

99253

E/M INITIAL IP/NF CONSULT NEW/

99254

E/M INITIAL IP/NF CONSULT NEW/

99255

E/M INITIAL IP/NF CONSULT NEW/

99383

E/M INITIAL PREV MED 5-11 YRS

99384

E/M INITIAL PREV MED AGE 12-17

99384

E/M INITIAL PREV MED AGE 12-17

99385

E/M INITIAL PREV MED AGE 18-39

99385

E/M INITIAL PREV.MED.AGE18-39

99386

E/M INITIAL PREV.MED.AGES40-64

99386

E/M INITIAL PREV MED AGE 40-64

99386

E/M INITIAL PREV.MED.AGES40-64

25

Proc AHSF Desc

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING

Proc Valid Gender Code B B F B B B B B B B B B B B B B B F B F B B F B

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

99387

E/M INITIAL PREV.MED.AGES 65 +

99387

E/M INITIAL PREV MED AGE 65 +

99387

E/M INITIAL PREV.MED.AGES 65 +

99393

E/M EST.PT. PREV.MED. AGES5-11

99394

E/M EST.PT.PREV.MED BY CNM

99394

E/M EST.PT.PREV.MED AGES12-17

99395

E/M PERIODIC EVAL EST PT

SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

99395

E/M PERIODIC EVAL EST. PATIENT

ALWAYS FAMILY PLANNING

F

99395

E/M PERIODIC EVALUATION EST PT

B

99395

E/M EST PT PREV MED AGE 18-39

99395

E/M PERIODIC EVAL IN FPCL CNM

99395

E/M EST.PT. PREV.MED. CNM

99395

E/M EST.PT. PREV.MED. AGE18-39

99396

E/M EST.PT. PREV.MED. CNM

99396

E/M EST.PT. PREV.MED. AGE40-64

99397

E/M EST.PT. PREV.MED. AGES65 +

99397

E/M EST.PT. PREV.MED. CNM

99397

E/M EST.PT. PREV.MED. AGE65 +

J0696

CEFTRIAXONE INJECTION 250 MG

J0696

CEFTRIAXONE INJECTION 250 MG

J1055

MEDROXYPROGESTERONE INJ 150MG

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

J1056

INJ,MEDROXYPROGESTERONE ACE/ES

ALWAYS FAMILY PLANNING

F

J1056

INJ,MEDROXYPROGESTERONE ACE/ES

ALWAYS FAMILY PLANNING

F

J3490

DRUGS UNCLASSIFIED INJECTION

ALWAYS FAMILY PLANNING

F

J7300

INTRAUT COPPER CONTRACEPTIVE

ALWAYS FAMILY PLANNING

F

J7302

LEVONORGESTREL-RELEASE IUD 52M

ALWAYS FAMILY PLANNING

F

J7303

CONTRACEPTIVE VAGINAL RING

ALWAYS FAMILY PLANNING

F

J7303

CONTRACEPTIVE VAGINAL RING

ALWAYS FAMILY PLANNING

F

J7304

CONTRACEPTIVE HORMONE PATCH

ALWAYS FAMILY PLANNING

F

26

B F B B F B B

B F F B F B B F B B B B

Procedure Code

Proc Layman Name

Proc AHSF Desc

Proc Valid Gender Code

J7304

CONTRACEPTIVE HORMONE PATCH

ALWAYS FAMILY PLANNING

F

J7307

ETONOGESTREL IMPLANT SYSTEM

ALWAYS FAMILY PLANNING

F

Q0111

WET MOUNT,PREP OF VAG.CERV.SK

F

Q0111

WET MOUNT,PREP OF VAG.CERV.SK

W9840

MEDICAL ENCOUNTER

Y7633

TEEN-DIRECTED FP SVCS INIT/YR

ALWAYS FAMILY PLANNING SOMETIMES FAMILY PLANNING SOMETIMES FAMILY PLANNING ALWAYS FAMILY PLANNING

Y7634

TEEN-DIRECTED FP SERVICE-F/U

ALWAYS FAMILY PLANNING

B

Z4334

PLAN B CONTRACEPTIVE KIT

ALWAYS FAMILY PLANNING

F

Source: NJ Medicaid Management Information System (MMIS) reference sub-system

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F B B

References i

NJ Department of Health and Senior Services, NJ Family Planning League. (2008). Family Planning Data Combined. ii Guttmacher Institute. (2006). Contraception Counts. Retrieved from: http://www.guttmacher.org/pubs/state_data/states/new_jersey.pdf iii

Ibid. iv Ibid. v NJ Department of Health and Senior Services, New Jersey Health Statistics, 2004. Retrieved from: http://www.state.nj.us/health/chs/stats04/natality.shtml vi Guttmacher Institute. (2006) vii ACOG and AAP. Guidelines for Perinatal Care, Sixth Edition, p.2. viii DS Feig, A. Razzaq, K. Syclora, J. Hux. GM Anderson. “Trends in Deliveries, Prenatal Care and Obstetrical Complications in Women with Pregestational Diabetes”. Diabetes Care; 2006; 29 (2); 232-235. ix U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Unintended Pregnancy Prevention x J. Edwards, J. Bronstein, and K. Adams, Evaluation of Medicaid Family Planning Demonstrations (The CAN Corporation, Nov. 2003), CMS Contract No. 752-2-415921:21. xi J.P. Mayer, “Unintended Childbearing, Maternal Beliefs, and Delay of Prenatal Care,” Birth 24, no.4 (1997). xii D. Belnap, (2008). Health Outcomes and Lower Costs Associated with Medicaid Family Planning Waivers. State Health Policy Briefing. xiii Ibid. xiv K. Kost et al., “The Effects of Pregnancy Planning Status on Birth Outcomes and Infant Care,” Family Planning Perspective 30, no. 5 (1998): 223-230. xv The National Campaign. Unplanned Pregnancy: Consequences of Unplanned Pregnancy Fact Sheet. xvi Center for Reproductive Rights. (2008). Title X Family Planning. Retrieved from: http://www.reproductiverights.org/pub_fac_titlex2.html xvii Guttmacher Institute. (2006) xviii New Jersey Primary Care Association. (2009). Description of Federally Funded/Qualified Health and Migrant Centers (FQHCs). Retrieved from: http://www.njpca.org/FQHC/default.aspx xix Iowa Department of Human Services. (2006). Family Planning. Retrieved from: http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/MWDL/itemdeta il.asp?filterType=dual,%20keyword&filterValue=family%20planning&fil terByDID=0&sortByDID=2&sortOrder=ascending&itemID=CMS028636 &intNumPerPage=10 xx Ibid.

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