All of the following
procedures and services require Prior Plan Notification and must be provided in
a SHP participating facility*:
o Inpatient and Observation Admissions, as noted above
o Admission to any rehabilitation and skilled nursing facility
o All surgical procedures, inpatient or outpatient
o The following have special reporting requirements (refer to Forms Section):
* Abortions
* Hysterectomies
* Sterilization procedures
o Cosmetic or Reconstructive Surgery, including but not limited to:
* Breast reconstruction or reduction
* Blepharoplasty
* Venous procedures
* Sclerotherapy
o Services and items:
* Allergy (immunotherapy), exept for those services identified on the QAF
* Ambulance transportation (non emergent)
* Amniocentesis
* Cardiac and pulmonary rehabilitation programs
* Circumcisions after 12 weeks of age
* Court-ordered services
* Chemotherapy
* Dialysis
* DME, including apnea monitors and bili-blankets
* Upper endoscopies at colonoscopies at hospitals
* Genetic testing
* Gamma Knife, Cyberknife
o Inpatient and Observation Admissions, as noted above
o Admission to any rehabilitation and skilled nursing facility
o All surgical procedures, inpatient or outpatient
o The following have special reporting requirements (refer to Forms Section):
* Abortions
* Hysterectomies
* Sterilization procedures
o Cosmetic or Reconstructive Surgery, including but not limited to:
* Breast reconstruction or reduction
* Blepharoplasty
* Venous procedures
* Sclerotherapy
o Services and items:
* Allergy (immunotherapy), exept for those services identified on the QAF
* Ambulance transportation (non emergent)
* Amniocentesis
* Cardiac and pulmonary rehabilitation programs
* Circumcisions after 12 weeks of age
* Court-ordered services
* Chemotherapy
* Dialysis
* DME, including apnea monitors and bili-blankets
* Upper endoscopies at colonoscopies at hospitals
* Genetic testing
* Gamma Knife, Cyberknife
