10- 144 C.M.R. ch. 272, § VI-V
Prior authorized services through the C.C.S./C.S.H.N. Program are available for congenital anomalies and gastrointestinal disorders as follows:
For those children who are referred by their primary care providers for subspecialty evaluation and/or treatment for such conditions as but not limited to: atresias of G.I.-tract, diaphragmatic hernia, Hirschsprung's disease, malrotation, omphalocele and tracheoesophageal fistula, the C.C.S./C.S.H.N. Program will pre-authorize payment for:
a diagnostic evaluation/consultation by a pediatric gastroenterologist and/or pediatric surgeon. This evaluation may include diagnostic studies and related hospitalization costs. surgical components of the plan of care and related hospitalization costs upon receipt of the report of the evaluation; office visits with the gastroenterologist; consultation with an approved feeding team that includes a speech language pathologist, occupational therapist and nutritionist if prescribed by the gastroenterologist; laboratory tests and imaging studies; and/or medications as prescribed by the gastroenterologist;For those children who are referred by their primary care providers for subspecialty evaluation and/or treatment for such conditions as but not limited to gastroesphogeal reflux, motility disorders, regional enteritis and/or ulcerative colitis, the C.C.S./C.S.H.N. Program will pre-authorize payment for:
a diagnostic evaluation/consultation by a pediatric gastroenterologist; surgical components of the plan of care and related hospitalization upon receipt of report of the evaluation; office visits with the gastroenterologist; laboratory tests and medications as prescribed by the gastroenterologist; and/or10- 144 C.M.R. ch. 272, § VI-V