467 NAC 3-010. HEART DIAGNOSIS AND SERVICES

010. HEART DIAGNOSIS AND SERVICES. This service provides treatment for congenital and acquired heart disease. 010.01 MEDICAL ELIGIBILITY CONSIDERATIONS. The most common diagnoses covered are Tetralogy of Fallot, transposition of the great vessels, and coarctation of the aorta, mitral/aortic valve stenosis, ventricular septal defect, and atrial septal defect. Other chronic heart conditions may be considered. 010.01(A) MEDICAL ELIGIBILITY DETERMINATION. The Department determines medical eligibility for heart diagnosis. The medical consultant only determines eligibility for heart diagnosis which falls under the “other diagnoses may be considered” category. 010.01(B) CERTIFICATION DATE. The certification date is the date of referral, once medical and financial eligibility is met. 010.02 SERVICE COMPONENTS. Service components may be covered if recommended in the individual medical treatment plan and funds are available.