WAC 182-532-120 Reproductive health - Covered yearly exams for women

WAC 182-532-120 Reproductive health—Covered yearly exams for women

Effective September 1, 2013

1. Along with services listed in WAC 182-531-0100, the medicaid agency covers one of the following yearly exams per client per year:
   1. A cervical, vaginal, and breast cancer screening exam; or
   2. A comprehensive prevention visit for family planning. (Under a delayed pelvic protocol, the comprehensive prevention visit for family planning may be split into two visits, per client, per year.)
2. The cervical, vaginal, and breast cancer screening examination:
   1. Must follow the guidelines of a nationally recognized protocol; and
   2. May be billed by a provider other than a TAKE CHARGE provider.
3. The comprehensive prevention visit for family planning:
   1. Must be provided by one or more qualified TAKE CHARGE providers. (See WAC 182-532-730.)
   2. Must include:
      1. A clinical breast examination and pelvic examination that follows the guidelines of a nationally recognized protocol; and
      2. Client-centered counseling that incorporates risk factor reduction for unintended pregnancy and anticipatory guidance about the advantages and disadvantages of all contraceptive methods.
   3. May include a pap smear according to current, nationally recognized clinical guidelines.
   4. Must be documented in the client's chart with detailed information that allows for a well-informed follow-up visit.
   5. Must be billed by a TAKE CHARGE provider only.