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Rule 67:16:42:05 Parenteral nutritional therapy.

          67:16:42:05.  Parenteral nutritional therapy. Parenteral nutritional therapy is covered if:


          (1)  The individual is not institutionalized and services are delivered in the individual's residence. For purposes of this rule, an individual's residence does not include an acute care hospital, a nursing facility, an intermediate care facility for individuals with intellectual disabilities, or an institution for individuals with a mental disease;


          (2)  The individual has a permanently inoperative internal body organ or an inoperative body function such as severe pathology of the alimentary tract which does not allow absorption of sufficient nutrients to maintain weight and strength commensurate with the individual's general condition;


          (3)  There is a physician's order or prescription for the therapy and medical documentation describing the diagnosis and the medical necessity for the therapy;


          (4)  The provider has received prior approval from the department; and


          (5)  Parenteral nutritional therapy is the only means the individual has to receive nutrition.


          Source: 22 SDR 32, effective September 11, 1995; 40 SDR 122, effective January 7, 2014; 40 SDR 122, effective January 8, 2014.

          General Authority: SDCL 28-6-1.

          Law Implemented: SDCL 28-6-1.


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