The following terms used in 130 CMR 423.000 have the meanings given in 130 CMR 423.402, unless the context clearly requires a different meaning. The reimbursability of services defined in 130 CMR 423.000 is not determined by these definitions, but by application of regulations elsewhere in 130 CMR 423.000 and 450.000: Administrative and Billing Regulations.
Freestanding Ambulatory Surgery Center -- a facility, geographically independent of any other health-care facility, that operates autonomously and functions exclusively for the purpose of providing outpatient same-day surgical, diagnostic, and medical services requiring a dedicated operating room and a postoperative recovery room. These surgical, diagnostic, and medical services provide diagnosis or treatment through operative procedures requiring general, local, or regional anesthesia to patients who do not require hospitalization or overnight services upon completion of the procedure, but who require constant medical supervision for a limited amount of time following the conclusion of the procedure. A freestanding ambulatory surgery center does not include individual or group-practice offices of private physicians, dentists, or podiatrists.These centers are referred to as surgical centers in 130 CMR 423.000.
Individual Consideration -- a designation given to a claim that will receive individual consideration (I.C.) to determine payment where a fee could not be established.
Institutionalized Individual - an individual who is
(1) involuntarily confined or detained, under a civil or criminal statute, in a correctional or rehabilitative facility, including a psychiatric hospital or other facility for the care and treatment of mental illness; or
(2) confined under a voluntary commitment, in a psychiatric hospital or other facility for the care and treatment of mental illness.
Mentally Incompetent Individual - an individual who has been declared mentally incompetent by a federal, state, or local court of competent jurisdiction for any purpose, unless the individual has been declared competent for purposes which include the ability to consent to sterilization.
Operative Report -- a report that states the operation performed, the name of the recipient, the date of the operation, the preoperative diagnosis, the postoperative diagnosis, the names of the surgeon and his or her assistants, and the technical procedures performed.
Sterilization - any medical procedure, treatment, or operation for the purpose of rendering an individual permanently incapable of reproducing.
130 CMR 423.402