410 IAC 3-3-3.5 Pulse oximetry measurement for critical congenital heart disease

Sec. 3.5. (a) Beginning July 1, 2021, except: (1) as provided for in section 2(b) of this rule; (2) for infants diagnosed with critical congenital heart disease prenatally; (3) for infants having received echocardiogram diagnostic testing prior to the required pulse oximetry screening; (4) for infants on supplemental oxygen or respiratory support for noncongenital heart diseases; or (5) for infants on palliative care; every newborn shall be given a pulse oximetry screening examination not earlier than twenty-four (24) and not later than forty-eight (48) hours after birth. (b) For infants exempted under subsection (a)(4), providers shall use best judgment for performing a pulse oximetry screening, after the infant has been removed from oxygen or respiratory support. (c) Pulse oximetry screenings shall be taken from pulse oximetry readings on the right hand and either foot. (d) A passing pulse oximetry reading is an initial reading or repeat reading, which is: (1) greater than or equal to ninety-five percent (95%) on the right hand and either foot screened in subsection (c); and (2) less than or equal to three percent (3%) variance between the right hand and either foot screened in subsection (c). (e) Except as provided in subsection (f), newborns who do not pass the initial pulse oximetry reading as described in subsection (d) shall have one (1) repeat reading following the initial screening performed one (1) hour after the initial reading. If the newborn does not pass the initial or repeat reading as described in subsection (d), the newborn shall be immediately assessed through an established clinical pathway for definitive diagnosis of critical congenital heart disease. (f) Newborns with an initial pulse oximetry reading of less than ninety percent (90%) in the right hand or foot shall be immediately assessed through an established clinical pathway for definitive diagnosis of critical congenital heart disease. (g) Newborns requiring immediate assessment as required in either subsection (e) or (f) shall be given, at a minimum, diagnostic testing via echocardiogram. (h) Providers shall ensure pulse oximetry screening information, including saturation percentages, is completed on the newborn's screening card or the religious refusal form, if applicable. If an infant meets an exception to pulse oximetry screening under subsection (a), the provider shall ensure that information is reported to the department in the monthly summary report.