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1E-3, Sterilization Procedures - ncdhhs

1E-3, Sterilization Procedures - ncdhhs 2025

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The document outlines the Clinical Coverage Policy No. 1E-3 for sterilization procedures under the Division of Medical Assistance, detailing the types of procedures covered (tubal ligation, hysteroscopic methods, and vasectomy), eligibility criteria for recipients, coverage conditions, consent requirements, and limitations on reimbursement. It specifies that sterilization is available to Medicaid recipients aged 21 and over who meet certain medical and legal criteria, while also providing guidelines for claims processing and documentation.

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What is the procedure code for sterilization?

Sterilization is any medical or surgical procedure intended to render the client permanently incapable of reproducing. This includes vasectomies (CPT code 55250), tubal ligations (CPT codes 58600, 58605, 58611, 58615, 58670, and 58671), and hysteroscopic sterilizations (CPT code 58565).

Is spousal consent required for sterilization?

The consent of the spouse is not required even if it incidentally will result in the sterilization of the patient. Statutes in Georgia, North Carolina, and Virginia requie the written consent of the patients spouse to voluntary sterilizations.

What consent is required for sterilization?

STATEMENT OF PERSON OBTAINING CONSENT To the best of my knowledge and belief the individual to be sterilized is at least 21 years old and appears mentally competent. He/She knowingly and voluntarily requested to be sterilized and appears to understand the nature and consequences of the procedure.

What is a sterilization consent form?

In 1974, the federal sterilization consent form (SCF) was created for those with publicly funded insurance to document appropriate informed consent by a clinician for sterilization procedures.

What are the criteria for sterilization?

Interval sterilization should be performed within 7 days of the menstrual period (in the follicular phase of the menstrual cycle). Post-partum sterilization should be done after 24 hours up to 7 days of delivery. Sterilization with medical termination of pregnancy (MTP) can be performed concurrently.

Does NC Medicaid cover female sterilization?

Medicaid shall cover sterilization procedures for both men and women age 21 and over. NCHC shall not cover Sterilization Procedures.

Does Medicare pay for sterilization?

Original Medicare does not cover sterilization to prevent reproduction. Tubal ligation may be covered in rare cases when the procedure is deemed medically necessary such as an effective treatment for disease. Some Medicare Advantage plans may cover the procedure.

1E-3, Sterilization Procedures - ncdhhs 2025

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