Section R9-4-501. Definitions

In this Article, unless otherwise specified:

1.        “Admitted” means the same as in A.A.C. R9-10-201.

2.        “Birth defect” means an abnormality:

a.         Of body structure, function, or chemistry, or of chro- mosomal structure or composition;

b.        That is present at or before birth; and

c.         That may be diagnosed before or at birth, or later in life.

3.        “Business day” means any day of the week other than a Saturday, a Sunday, a legal holiday, or a day on which the Department is authorized or obligated by law or execu- tive order to close.

4.        “Calendar day” means any day of the week, including a Saturday or a Sunday.

5.        “Clinic” means:

a.         A person under contract or subcontract with CRS to provide the medical services specified in 9 A.A.C. 7, Article 4;

b.        An outpatient treatment center, as defined in A.A.C.

R9-10-101, or

c.         An outpatient surgical center, as defined in A.A.C. R9-10-101.

6.        “Clinical evaluation” means an examination of the body of an individual and review of the individual’s laboratory

test results to determine the presence or absence of a medical condition.

7.        “Clinical laboratory” means a facility that:

a.         Meets the definition in A.R.S. § 36-451;

b.        Is operated, licensed, or certified by the U.S. govern- ment; and

c.         Is located within Arizona.

8.        “Code” means a single number or letter, a set of numbers or letters, or a set of both numbers and letters, that repre- sents specific information.

9.        “Conception” means the formation of an entity by the union of a human sperm and ovum, resulting in a preg- nancy.

10.     “Co-twin” means a sibling of a patient, who was born to the same mother as the patient and as a result of the same pregnancy as the patient.

11.     “CRS” means the Children’s Rehabilitative Services pro- gram, established within the Department as specified in

A.R.S. Title 36, Chapter 2, Article 3.

12.     “Date of first contact” means the day, month, and year a physician, clinic, or other person specified in R9-4- 503(A) first began to provide medical services, nursing services, or health-related services to a patient or the patient’s mother.

13.     “Date of last contact” means the day, month, and year:

a.         Of a patient’s death; or

b.        That a physician, clinic, or other person specified in R9-4-503(A) last clinically evaluated, diagnosed, or provided treatment to a patient or the patient’s mother.

14.     “Designee” means an individual assigned by the govern- ing power of a hospital, high-risk perinatal practice, genetic testing facility, or prenatal diagnostic facility or by another individual acting on behalf of the governing power to gather information for or report to the Depart- ment, as specified in R9-4-502, R9-4-503, or R9-4-504.

15.     “Discharge” means the same as in A.A.C. R9-10-201.

16.     “Discharge date” means the month, day, and year of an individual’s discharge from a hospital.

17.     “Electronic” means the same as in A.R.S. § 44-7002.

18.     “Enrolled” means approved to receive services specified in 9 A.A.C. Chapter 7 from CRS.

19.     “Estimated date of confinement” means an approxima- tion of the date on which a woman will give birth, based on the clinical evaluation of the woman.

20.     “Estimated gestational age” means an approximation of the duration of a pregnancy, based on the date of the last menstrual period of the pregnant woman.

21.     “Facility” means a building and associated personnel and equipment that perform or are used in connection with performing a particular service or activity.

22.     “Family medical history” means an account of past and present illnesses or diseases experienced by individuals who are biologically related to a patient.

23.     “Follow-up services” means activities intended to assist the parent or guardian of a patient who has a birth defect to:

a.         Learn about the birth defect and, if applicable, how the birth defect may be prevented; or

b.        Obtain  applicable  medical  services,   nursing  ser- vices, health-related services, or support services.

24.     “Genetic condition” means a disease or other abnormal state present at birth or before birth, as a result of an alter- ation of DNA, that impairs normal physiological func- tioning of a human body.

25.     “Genetic testing facility” means an organization, institu- tion, corporation, partnership, business, or entity that con- ducts tests to detect, analyze, or diagnose a genetic condition in an individual, including an evaluation to determine the structure of an individual’s chromosomes.

26.     “Governing power” means the individual, agency, group, or corporation appointed, elected, or  otherwise desig- nated, in which the ultimate responsibility and authority for the conduct of a hospital, high-risk perinatal practice, genetic testing facility, or prenatal diagnostic facility are vested.

27.     “Guardian” means  an individual  appointed  as a legal guardian by a court of competent jurisdiction.

28.     “Health-related services” means the same as in A.R.S. § 36-401.

29.     “High-risk perinatal practice” means a clinic or physician that routinely provides medical services prenatally to a patient or a patient’s mother with perinatal risk factors to prevent, clinically evaluate, diagnose, or treat the patient for a possible birth defect.

30.     “Log” means a chronological list of individuals for or on whom medical services, nursing services, or health- related services were provided by a designated unit of a hospital or by another person specified in R9-4-503(A).

31.     “Medical condition” means a disease, injury, other abnor- mal physiological state, or pregnancy.

32.     “Medical records” means the same as in A.R.S. § 12- 2291.

33.     “Medical record number” means a unique number assigned by a hospital, clinic, physician, or registered nurse practitioner to an individual for identification pur- poses.

34.     “Medical services” means the same as in A.R.S. § 36- 401.

35.     “Midwife” means an individual licensed under A.R.S. Title 36, Chapter 6, Article 7, or certified under A.R.S. Title 32, Chapter 15.

36.     “Mother” means the woman:

a.         Who is pregnant with or gives birth to a patient, or

b.        From whose fertilized egg a patient develops.

37.     “Multiple gestation” means a pregnancy in which a patient is not the only fetus carried in a mother’s womb.

38.     “Nursing services” means the same as in A.R.S. § 36- 401.

39.     “Ordered” means instructed by a physician, registered nurse practitioner, or physician assistant to perform a test on an individual.

40.     “Parent” means the:

a.         Biological or adoptive father of an individual; or

b.        Woman who:

i.         Is the mother of an individual; or

ii.        Adopts an individual.

41.     “Pathology laboratory” means a facility in which human cells, body fluids, or tissues are examined for the purpose of  diagnosing   diseases  and  that   is  licensed  under  9

A.A.C. 10, Article 1.

42.     “Patient” means an individual, regardless of current age:

a.         Who, from conception to one year of age, was clini- cally evaluated for a possible birth defect or a medi- cal condition that may be related to a birth defect:

i.         By:

(1)     A physician,

(2)     A midwife,

(3)     A registered nurse practitioner, or

(4)     A physician assistant; or

ii.       At a hospital or clinic;

b.        Whose mother was clinically evaluated during her pregnancy with the individual:

i.         For a medical condition that may be related to a possible birth defect, and

ii.        By an individual or facility specified in subsec- tion (42)(a);

c.         Who, from conception to one year of age, was tested by a genetic testing facility or other clinical labora- tory;

d.        Whose mother was tested during her pregnancy with the individual by a:

i.         Genetic testing facility or other clinical labora- tory, or

ii.       Prenatal diagnostic facility; or

e.         Who, from conception to one year of age, was pro- vided treatment or whose mother during her preg- nancy with the individual was provided treatment by a hospital, clinic, physician, registered nurse practi- tioner, or other person specified in R9-4-503(A) for a medical condition that may be related to a possible birth defect.

43.     “Perinatal risk factor” means a situation or circumstance that may increase the chance of an individual being born with a birth defect, such as:

a.         A family medical history of birth defects or other medical conditions;

b.        The exposure of the individual or the individual’s mother or biological father to radiation, medicines, chemicals, or diseases before the individual’s birth; or

c.         An abnormal result of a test performed for the indi- vidual or the individual’s mother by a prenatal diag- nostic facility or clinical laboratory, including a genetic testing facility.

44.     “Physician assistant” means an individual licensed under

A.R.S. Title 32, Chapter 25.

45.     “Prenatal diagnostic facility” means an organization, institution, corporation, partnership, business, or entity that conducts diagnostic ultrasound or other medical pro- cedures that may diagnose a birth defect in a human being.

46.     “Principal diagnosis” means the primary reason for which an individual is:

a.         Admitted to a hospital;

b.        Treated by a hospital, clinic, physician, registered nurse practitioner, or physician assistant; or

c.         Tested by a genetic testing facility or prenatal diag- nostic facility.

47.     “Procedure” means a set of activities performed on a patient or the mother of a patient that:

a.         Are invasive;

b.        Are intended to diagnose or treat a disease, illness, or injury;

c.         Involve a risk to the patient or patient’s mother from the activities themselves or from anesthesia; and

d.        Require the individual performing the set of activi- ties to be trained in the set of activities.

48.     “Refer” means to provide direction to an individual or the individual’s parent or guardian to obtain medical services or a test for assessment, diagnosis, or treatment of a birth defect or other medical condition.

49.     “Registered nurse practitioner” means an individual who meets the definition of registered nurse practitioner in

A.R.S. § 32-1601, and is licensed under A.R.S. Title 32, Chapter 15.

50.     “Routinely” means occurring in the regular or customary course of business.

51.     “Secondary diagnosis” means all other diagnoses for an individual besides the principal diagnosis.

52.     “Singleton gestation” means a pregnancy in which a patient is the only fetus carried in a mother’s womb.

53.     “Support services” means activities, not related to the diagnosis or treatment of a birth defect, intended to main- tain or improve the physical, mental, or psychosocial capabilities of a patient or those individuals biologically or legally related to the patient.

54.     “Surgical procedure” means making an incision into an individual’s body for the:

a.         Correction of a deformity or defect,

b.        Repair of an injury,

c.         Excision of a part of the individual’s body, or

d.        Diagnosis, amelioration, or cure of a disease.

55.     “Test” means:

a.         An analysis performed on body fluid, tissue, or excretion by a genetic testing facility or other clini- cal laboratory to evaluate for the presence or absence of a disease; or

b.        A procedure performed on the body of a patient or the patient’s mother that may be used to evaluate for the presence or absence of a birth defect.

56.     “Transfer” means for a hospital to discharge a patient or the patient’s mother and send the patient or the patient’s mother to another hospital for inpatient medical services without the intent that the patient or the patient’s mother will return to the sending hospital.

57.     “Treatment” means the same as in A.A.C. R9-10-101.

58.     “Unit” means an area of a hospital designated to provide an organized service, as defined in A.A.C. R9-10-201.

Historical Note

Adopted effective September 25, 1991 (Supp. 91-3). Former Section R9-4-501 renumbered to R9-4-502; new Section R9-4-501 adopted by final rulemaking at 7

A.A.R. 712, effective January 17, 2001 (Supp. 01-1). Amended by final rulemaking at 13 A.A.R. 1702,

effective June 30, 2007 (Supp. 07-2).