On March 10, 2014, a team from Illinois and Washington made a presentation to the Hospital Outpatient Payment (HOP) Panel that would move a series of codes from direct physician supervision to the general supervision category. CMS has rendered a PRELIMINARY decision pursuant to regulation that agreed with some recommendations, reversed others and altered one. The list of recommend changes and the CMS preliminary decision on each is listed below:
36430 Blood Transfusion Services—change from direct supervision to extended duration
36593 Declot Vascular Devices—change to general supervision
96401 Chemo anti-neo sq/IM—keep direct supervision
96402 Chemo horma anti/neo sq/IM—keep direct supervision
96409 Chemo IV push single drug—keep direct supervision
96411 Chemo IV push add/drug—keep direct supervision
96413 Chemo IV infusion/hr—keep direct supervision
96413 Chemo IV infusion add I hour—keep direct supervision
96416 Chemo prolong infusion with push—keep direct supervision
96417 Chemo IV infusion addl sequ—keep direct supervision
94667 Chest wall manipulation/percussion—change to general supervision
94668 Chest wall manipulation—change to general supervision
36600 Withdrawal arterial Blood—change to general supervision
97597 Pulse lavage/wound cleansing—keep direct supervision
NRHA encourages all members to write CMS by using this link and ask that CMS follow the HOP Panel recommendations and move the procedures above identified as staying on direct supervision to general level supervision. This is an access issue for our rural patients. If CMS doesn’t hear from you and how these procedures can be done safely at your facility, then we’ve missed the regulatory process that was designed to remove the burden of unnecessary regulation in this area. Let the experts that CMS assembled to advise them on these procedures be the voice of reason.