For purposes of this part, the following definitions will apply:

1. (1) "Acquired craniofacial anomaly" means a craniofacial condition caused or brought on only by trauma or tumor;
2. (2) "Craniofacial anomaly" means the abnormal development of the skull and face;
3. (3) "Healthcare service" means a healthcare procedure, treatment, or service provided by a medical provider;
4. (4) "Medical provider" means a person who performs healthcare services for patients with a craniofacial anomaly;
5. (5) “Nonurgent healthcare service” means any craniofacial healthcare service that is not urgent;
6. (6) "Reconstructive surgery" means the use of surgery to alter the form and function of cranial facial tissues due to a congenital or acquired musculoskeletal disorder, including surgery to alter the form and function of the skull and face;
7. (7) "Surgical team member" means a surgical member of an American Cleft Palate-Craniofacial Association-approved team who specializes in craniofacial anomaly reconstructive surgery or a surgical member of an approved team with requisite and equivalent craniofacial surgical experience in the field of service requested to be reviewed; and

8. (8) "Urgent healthcare service" means a craniofacial healthcare service for a non-life-threatening condition that, in the opinion of a provider with knowledge of a craniofacial patient's medical condition, requires prompt medical care in order to prevent:

   1. (A) A serious threat to life, limb, or eyesight;
   2. (B) Worsening impairment of a bodily function that threatens the body's ability to regain maximum function;
   3. (C) Worsening dysfunction or damage of any bodily organ or part that threatens the body's ability to recover from the dysfunction or damage; or
   4. (D) Severe pain that cannot be managed without prompt medical care.