Ariz. Admin. Code § 9-4-501

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-4-501 - Definitions

In this Article, unless otherwise specified:

1. "Birth defect" means an abnormality:

a. Of body structure, function, or chemistry, or of chromosomal structure or composition;

b. That is present at or before birth; and

c. That may be diagnosed before or at birth, or later in life.

2. "Clinic" means:

a. A person under contract or subcontract with the Arizona Health Care Cost Containment System to provide the services specified in 9 A.A.C. 22, Article 13;

b. An outpatient treatment center, as defined in A.A.C. R9-10-101;

c. An outpatient surgical center, as defined in A.A.C. R9-10-101; or

d. A birth center, as defined in A.A.C. R9-13-201.

3. "Clinical evaluation" means an examination of the body of an individual and review of the individual's laboratory test results to determine the presence or absence of a medical condition that may be related to a birth defect.

4. "Conception" means the formation of an entity by the union of a human sperm and ovum, resulting in a pregnancy.

5. "Co-twin" means a sibling of a patient, who was born to the same mother as the patient and as a result of the same pregnancy as the patient.

6. "Date of first contact" means the day, month, and year a physician, clinic, or other person specified in R9-4-503(A) first began to provide medical services, nursing services, or health-related services to a patient or the patient's mother.

7. "Date of last contact" means the day, month, and year:

a. Of a patient's death; or

b. That a physician, clinic, or other person specified in R9-4-503(A) last clinically evaluated, diagnosed, or provided treatment to a patient or the patient's mother.

8. "Designee" means an individual assigned by the governing power of a hospital, high-risk perinatal practice, genetic testing facility, or prenatal diagnostic facility or by another individual acting on behalf of the governing power to gather information for or report to the Department, as specified in R9-4-502, R9-4-503, or R9-4-504.

9. "Estimated date of confinement" means an approximation of the date on which a woman will give birth, based on the clinical evaluation of the woman.

10. "Estimated gestational age" means an approximation of the duration of a pregnancy, based on the date of the last menstrual period of the pregnant woman.

11. "Facility" means a building and associated personnel and equipment that perform or are used in connection with performing a particular service or activity.

12. "Family medical history" means an account of past and present illnesses or diseases experienced by individuals who are biologically related to a patient.

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13. "Genetic testing facility" means an organization, institution, corporation, partnership, business, or entity that conducts tests to detect, analyze, or diagnose a disease or other abnormal state present at birth or before birth, as a result of an alteration of DNA, that may impair normal physiological functioning in an individual, including an evaluation to determine the structure of an individual's chromosomes.

14. "Governing power" means the individual, agency, group, or corporation appointed, elected, or otherwise designated, in which the ultimate responsibility and authority for the conduct of a hospital, high-risk perinatal practice, genetic testing facility, or prenatal diagnostic facility are vested.

15. "High-risk perinatal practice" means a clinic or physician that routinely provides medical services prenatally to a patient or a patient's mother with perinatal risk factors to prevent, clinically evaluate, diagnose, or treat the patient for a possible birth defect.

16. "Log" means a chronological list of individuals for or on whom medical services, nursing services, or health-related services were provided by a designated unit of a hospital or by another person specified in R9-4-503(A).

17. "Medical condition" means a disease, injury, other abnormal physiological state, or pregnancy.

18. "Medical record number" means a unique number assigned by a hospital, clinic, physician, or registered nurse practitioner to an individual for identification purposes.

19. "Midwife" means an individual licensed under A.R.S. Title 36, Chapter 6, Article 7, or certified under A.R.S. Title 32, Chapter 15.

20. "Mother" means the woman:

a. Who is pregnant with or gives birth to a patient, or

b. From whose fertilized egg a patient develops.

21. "Multiple gestation" means a pregnancy in which a patient is not the only fetus carried in a mother's womb.

22. "Patient" means an individual, regardless of current age:

a. Who, from conception to one year of age, was clinically evaluated for a possible birth defect or a medical condition that may be related to a birth defect:

i. By a physician, midwife, registered nurse practitioner, or physician assistant ; or

ii. At a hospital or clinic;

b. Whose mother was clinically evaluated during her pregnancy with the individual:

i. For a medical condition that may be related to a possible birth defect, and

ii. By an individual or facility specified in subsection (22)(a);

c. Who, from conception to one year of age, was tested by a genetic testing facility or other clinical laboratory;

d. Whose mother was tested during her pregnancy with the individual by a:

i. Genetic testing facility or other clinical laboratory, or

ii. Prenatal diagnostic facility;

e. Who, from conception to one year of age, was provided treatment or whose mother during her pregnancy with the individual was provided treatment by a hospital, clinic, physician, registered nurse practitioner, or other person specified in R9-4-503(A) for a medical condition that may be related to a possible birth defect; or

f. Who has received a diagnosis of having a medical condition that may be related to a birth defect.

23. "Perinatal risk factor" means a situation or circumstance that may increase the chance of an individual being born with a birth defect, such as:

a. A family medical history of birth defects or other medical conditions;

b. The exposure of the individual or the individual's mother or biological father to radiation, medicines, chemicals, or diseases before the individual's birth; or

c. An abnormal result of a test performed for the individual or the individual's mother by a prenatal diagnostic facility or clinical laboratory, including a genetic testing facility.

24. "Prenatal diagnostic facility" means an organization, institution, corporation, partnership, business, or entity that conducts diagnostic ultrasound or other medical procedures that may diagnose a birth defect in a human being.

25. "Principal diagnosis" means the primary reason for which an individual is:

a. Admitted to a hospital;

b. Treated by a hospital, clinic, midwife, physician, registered nurse practitioner, or physician assistant; or

c. Tested by a genetic testing facility or prenatal diagnostic facility.

26. "Procedure" means a set of activities performed on a patient or the mother of a patient that:

a. Are invasive;

b. Are intended to diagnose or treat a disease, illness, or injury;

c. Involve a risk to the patient or patient's mother from the activities themselves or from anesthesia; and

d. Require the individual performing the set of activities to be trained in the set of activities.

27. "Refer" means to provide direction to an individual or the individual's parent or guardian to obtain medical services or a test for assessment, diagnosis, or treatment of a birth defect or other medical condition.

28. "Routinely" means occurring in the regular or customary course of business.

29. "Secondary diagnosis" means all other diagnoses that may be related to a birth defect for an individual besides the principal diagnosis.

30. "Singleton gestation" means a pregnancy in which a patient is the only fetus carried in a mother's womb.

31. "Support services" means activities, not related to the diagnosis or treatment of a birth defect, intended to maintain or improve the physical, mental, or psychosocial capabilities of a patient or those individuals biologically or legally related to the patient.

32. "Surgical procedure" means making an incision into an individual's body for the:

a. Correction of a deformity or defect,

b. Repair of an injury,

c. Excision of a part of the individual's body, or

d. Diagnosis, amelioration, or cure of a disease.

33. "Test" means:

a. An analysis performed on body fluid, tissue, or excretion by a genetic testing facility or other clinical laboratory to evaluate for the presence or absence of a disease; or

b. A procedure performed on the body of a patient or the patient's mother that may be used to evaluate for the presence or absence of a birth defect.

34. "Transfer" means for a hospital to discharge a patient or the patient's mother and send the patient or the patient's mother to another hospital for inpatient medical services without the intent that the patient or the patient's mother will return to the sending hospital.

35. "Treatment" means the same as in A.A.C. R9-10-101.

36. "Unit" means an area of a hospital designated to provide an organized service, as defined in A.A.C. R9-10-201.

Ariz. Admin. Code § R9-4-501

Adopted effective September 25, 1991 (Supp. 91-3). Former Section R9-4-501 renumbered to R9-4-502; new Section R9-4-501adopted by final rulemaking at 7 A.A.R. 712, effective January 17, 2001 (Supp. 01-1). Amended by final rulemaking at 13 A.A.R. 1702, effective June 30, 2007 (Supp. 07-2). Amended by final rulemaking at 25 A.A.R. 3429, effective 1/1/2020.