Clarification on Sterilization Consent Form

On Feb. 1, 2016, two new versions of the sterilization consent form were posted to the DMA website prior to their actual implementation date. In order to avoid a delay in claims processing, it is recommended that, when possible, providers have the beneficiary sign one of the old forms (consisting of 2 columns on one page) which can be found in Clinical Coverage Policy 1E-3 “Sterilization Procedures�, Attachment C. (See link below.) System changes will be made to accommodate the newer form. Until that time, if either of the new forms are used, there will be a delay in processing of the form, which could result in claim denial until the consent form is approved in the system. Providers should use the old form until they are notified to use the new form and are provided instructions for the new form in the Sterilization Procedures policy.